A 64 year old man with newly diagnosed hypertension returns for continuation of therapy titration. He has no other cardiac risk factors. He has complained of difficult initiating his urinary stream in the past, but does not want to consider surgery, unless his symptoms worsen. Devise a therapeutic plan for this patient's second step antihypertensive agent that could provide relief for his mild-moderate obstructive uropathy symptoms. He also has a 12 year history of intermittent, unilateral, throbbing headache which has been diagnosed as a migraine.
Pupils are round and react to light and accommodation.
Fundi without nicking, or narrowing of arterioles, exudates, hemorrhages, or papilledema. No JVD is noted. S1 and S2 are of equal intensity. No murmur, rub, or thrill. No aortic, renal, iliac or femoral bruits are noted.