[Solved]: A 41-year-old man presents to his primary care…

A 41-year-old man presents to his primary care provider because of chest pain with activity for the past 6 months. Past medical/surgical history is significant for hypertension, type 2 diabetes mellitus that is poorly controlled, and an appendectomy at age 12. He takes metformin and lisinopril but admits that he forgets to take them every day. His father had a heart attack at age 41, and 2 stents were placed in his heart. His mother is healthy. He drinks alcohol occasionally and smokes half a pack of cigarettes daily. He is a sales executive and describes his work as stressful. Today, his blood pressure is 142/85 mm Hg and his body mass index (BMI) is 38.5. His stress test was abnormal and coronary angiography showed > 75% narrowing of the left anterior descending coronary artery. Which of the following is the most significant risk factor in this patient? A. Poorly controlled diabetes mellitus B. Hypertension C. Family history D. Obesity E. Smoking