<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 30-year-old African American man comes to the doctors office for an annual checkup. He feels healthy and his only concern is an occasional headache after work. Past medical history is significant for an appendectomy 10 years ago and a fractured arm playing football in high school. His mother has type 2 diabetes mellitus, while his father and grandfather both have hypertension. He does not drink alcohol, smoke cigarettes, or use drugs. His vital signs include: pulse 78min and regular, respiratory rate 16min, and temperature 36.8C 98.2F. Physical examination reveals an overweight African American man 167 cm 5 ft 6 in tall and weighing 80 kg 176 lb with a protuberant belly. BMI is 28.7 kgm2. The remainder of the examination is unremarkable. During his last 2 visits, his blood pressure readings have been 14086 mm Hg and 13682 mm Hg. Today his blood pressure is 13686 mm Hg and his laboratory tests show:Serum Glucose fasting 90.0 mgdLSerum Electrolytes: Sodium 142.0 mEqLPotassium 3.9 mEqLChloride 101.0 mEqLSerum Creatinine 0.8 mgdLBlood urea nitrogen 9.0 mgdLUrinalysis:Glucose NegativeKetones NegativeLeukocytes NegativeNitrite NegativeRBCs NegativeCasts NegativeWhich of the following is the next best step in the management of this patient?? A: Start him on lisinopril., B: Start him on hydrochlorothiazide., C: Order a glycosylated hemoglobin test HbA1c., D: Start him on hydrochlorothiazide and lisinopril together., E: Recommend weight loss, more exercise, and a salt-restricted diet.,  <response>: This is a question about the management of a 30-year-old African American man with slightly elevated blood pressure at his annual checkup. The key findings are:- Overweight BMI 28.7 kgm2 - Family history of diabetes mother and hypertension father and grandfather- Blood pressure readings of 14086 mm Hg and 13682 mm Hg at previous 2 visits, and 13686 mm Hg today- Fasting blood glucose of 90 mgdL at upper end of normal range- Otherwise unremarkable history, exam, and lab testsThe choices given are different medication options lisinopril, hydrochlorothiazide, both versus lifestyle modifications. This patient has stage 1 hypertension based on his elevated blood pressures. Lifestyle modifications including weight loss, diet, and exercise are first-line recommendations for stage 1 hypertension per guidelines. Medications would be indicated if his blood pressure remains elevated despite lifestyle changes. There are no indications for checking HbA1c at this time.E: Recommend weight loss, more exercise, and a salt-restricted diet. 