A 35-year-old man is evaluated during a routine examination. He is asymptomatic but is interested in starting a diet and exercise program. In high school, he was athletic, thin, and fit, but since then, he has gradually gained weight. He works very long hours in a sedentary job, does not exercise, and occasionally smokes a cigar. He drinks two to three alcoholic beverages per day on weekends, and he often eats fast food. He reports occasional snoring, but he feels refreshed when awaking in the morning. He reports no daytime somnolence or sleep intrusions. He does not have exertion-associated symptoms suggestive of cardiac ischemia. Medical history is unremarkable. He takes no medications.

On physical examination, the patient is afebrile, blood pressure is 126/76 mm Hg, and pulse rate is 78/min. BMI is 31. The abdomen is protuberant without pathologic striae. The remainder of the examination is normal.

Which of the following is the most appropriate cardiovascular risk stratification strategy?