A 52-year-old patient with obesity presents with BP 148/92 mmHg, LDL 160 mg/dL, HDL 35 mg/dL, and triglycerides 240 mg/dL. Using integrated risk reasoning, which management priorities should be addressed first to reduce cardiovascular risk?

Advise stopping any physical activity because exercise could temporarily raise heart rate and further harm cardiovascular health in people with high LDL

Treat only the low HDL with niacin and ignore blood pressure and LDL because HDL is the only lipid linked to heart disease in obesity

Delay treatment and focus solely on cosmetic weight-loss surgery since immediate cardiovascular signs are not urgent compared with appearance concerns

Prioritize blood-pressure control and lipid management (reduce LDL and triglycerides, raise HDL as possible) while initiating lifestyle interventions for weight reduction and addressing diabetes screening because hypertension and dyslipidemia are immediate modifiable cardiovascular risks