A 68-year-old man with a history of ischemic cardiomyopathy (ejection fraction 28%) and stage 3 chronic kidney disease presents to clinic with progressive dyspnea on exertion over the past 2 weeks. He reports orthopnea and lower extremity swelling. Current medications include lisinopril 10 mg daily, metoprolol succinate 95 mg daily, and furosemide 40 mg daily. Vital signs: BP 142/88 mmHg, HR 98/min, RR 20/min, SpO2 96% on room air. Laboratory values show: serum potassium 6.1 mmol/L (normal 3.5-5.0), creatinine 2.2 mg/dL (baseline 2.0), BUN 48 mg/dL, and LVEF remains 28% on transthoracic echocardiogram. Physical examination confirms bilateral lower extremity pitting edema and elevated jugular venous pressure. Which of the following is the most appropriate next step in management?

1. A)Discontinue lisinopril immediately and initiate sodium polystyrene sulfonate therapy
2. B)Increase furosemide dose and reduce lisinopril dose from 10 mg to 5 mg dailyGABARITO
3. C)Add spironolactone 12.5 mg daily to improve heart failure outcomes while monitoring potassium
4. D)Discontinue lisinopril and metoprolol, and initiate hydralazine/isosorbide dinitrate instead
5. E)Continue all current medications and add patiromer to allow continuation of renin-angiotensin-aldosterone system inhibition