Review Question - QID 214917

A 50-year-old man presents to the primary care clinic for a routine health maintenance examination. He has no acute complaints. The patient has a past medical history of hypertension and osteoarthritis of the knee for which he takes chlorthalidone and ibuprofen. The patient’s temperature is 98.4°F (36.9°C), blood pressure is 140/90 mmHg, pulse is 75/min, and respirations are 16/min. His BMI is 32 kg/m^2. Physical exam reveals a well-appearing Caucasian man with a normal body fat distribution and without abnormal skin lesions or abdominal striae. Mucous membranes are moist. His fasting lab results are as follows:

Serum:
Na+: 138 mEq/L
Cl-: 101 mEq/L
K+: 4.4 mEq/L
HCO3-: 24 mEq/L
BUN: 16 mg/dL
Glucose: 118 mg/dL
Creatinine: 1.0 mg/dL
Triglycerides: 210 mg/dL
High-density lipoprotein (HDL) cholesterol: 55 mg/dL
Low-density lipoprotein (LDL) cholesterol: 110 mg/dL

Which of the following is the underlying pathophysiology of this patient's disease process?