Telmisartan 80 as the very first dose in a 63-year-old is a bit aggressive; I would start 40 mg and step up in 2-4 weeks if BP stays above 140/90. His urine ACR of 46 shows early
kidney involvement, so telmisartan is exactly the right drug class here, just at a sensible dose.
LDL 174 with hypertension and albuminuria does justify a statin, so rosuvastatin 10 mg is reasonable. Gabantin and Symbal do not clash with either, though BP may dip more when combined with duloxetine, so watch for giddiness on standing.
Next Steps
Start with the 40 mg strength, log home BP twice daily for 2 weeks, and repeat
creatinine, potassium and urine ACR after 2-3 weeks of starting it. If he gets chest pain, sudden breathlessness or one-sided weakness, that is an emergency, not a dose question. Send me his BP diary on an online consult and I will titrate the dose for you.