Not business as usual

A 56-YEAR-OLD business executive is referred for assessment and exercise stress testing following a history suggestive of recent onset exertional angina.

He has a four-year history of mild hypertension treated with an ARB daily. He has a history of hyperlipidaemia managed by diet. Total cholesterol is 6.4, LDL 3.9. There is a soft family history and a history of smoking for some 10 years till the age of 40. He has been under considerable recent personal and work-related stress with a lot of business that required overseas travel and a less than optimal diet.