Review the typical conventional treatment approach
Clearly Jim is a person who could benefit from hypertensive medication. He has persistently elevated blood pressure on multiple occasions. He has more than one risk factor for heart disease. Many would argue to begin anti-hypertensive medication at this visit. The University of Michigan's Clinical Care Guidelines for hypertension suggest starting with a thiazide diuretic, ACE inhibitor, or long-acting dihydropyridine calcium channel blocker for almost all patients, then adding second and third agents as needed to achieve effective BP reduction goals.
Starting a conventional medication regime does not rule out additional non-pharmaceutical options, such as modifying lifestyle risk factors (e.g., weight, dietary intake or physical activity) or added stress management practices.