A 5.3 will put you about where you would be with 3.73 and OD locked out, which is what is going to happen anyway when you hit a grade. If that's not enough, the transmission can drop down yet another gear and with 3.73 you'll be able to run at least 50 mph without getting close to the 5800 rpm redline of the V-10. My truck with 3.73 gears and 16-inch wheels does the 2-3 shift at about 60 mph on hard acceleration.
If you want to tow up hills in overdrive, you might consider 4.10 gearing, which is probably about as far as you can go with ring and pinion gear swaps. There are heavier Dana axles with 4.56 and 5.38 gearing used in Ford chassis, but that might mean an axle swap, not just a gear swap.