<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 67-year-old man comes to the office due to pain in the lower part of his calves on his afternoon walk to get the mail. The pain is relieved by rest. It started slowly about 6 months ago and has become more painful over time. He has a history of hypertension, hyperlipidemia, diabetes mellitus, and smoking. Medications include hydrochlorothiazide, atorvastatin, metformin, and a multivitamin that he takes daily. The patient does not smoke and only drinks socially. Today, his blood pressure is 14590 mm Hg, pulse is 75min, respiratory rate is 17min, and temperature is 37.6C 99.6F. On physical exam, he appears mildly obese and healthy. His heart has a regular rate and rhythm, and his lungs are clear to auscultation bilaterally. Examination of the legs shows atrophic changes and diminished pedal pulses. A measure of his ankle brachial index ABI is 0.89. Which of the following is the most appropriate initial treatment?? A: Enoxaparin, B: Metoprolol, C: A recommendation to perform pedal pumping exercises, D: A recommendation to walk more, E: A referral to a supervised exercise program,  <response>: This is a question about a 67-year-old man with calf pain on walking that is relieved by rest. He has a history of hypertension, hyperlipidemia, diabetes mellitus, and smoking. His medications include a thiazide diuretic, statin, metformin, and a multivitamin. On exam, he has diminished pedal pulses and an ABI of 0.89, consistent with peripheral arterial disease. The choices include anticoagulation with enoxaparin, beta blocker therapy with metoprolol, pedal pumping exercises, increasing walking, and referral to a supervised exercise program. In peripheral arterial disease, supervised exercise therapy is recommended as initial treatment to improve symptoms and functional status. Anticoagulation and beta blockers would not be appropriate initial therapy. While pedal pumping exercises and increasing walking may help, referral to a structured program would provide the most benefit.E: A referral to a supervised exercise program 