Final answer:
An ACE inhibitor is recommended to be added for the management of hypertension in a 38-year-old African American male already on a thiazide-type diuretic, given his current blood pressure readings and absence of diabetes or chronic kidney disease.
Step-by-step explanation:
For the 38-year-old African American male with hypertension you mention in your question, since he is already on a thiazide-type diuretic and his blood pressure remains high at 156/94 mm Hg, current best evidence suggests adding another antihypertensive agent. Considering that he has no history of diabetes mellitus or chronic kidney disease, the addition of an ACE inhibitor could help to lower his blood pressure further. ACE inhibitors work by blocking the conversion of angiotensin I to angiotensin II, which helps in reducing blood pressure. Beta-blockers could also be considered, however, they are no longer recommended as a first line of treatment unless there are other indications such as heart failure or after a heart attack. Calcium channel blockers are another option that can be effective, particularly in the African American population with hypertension. Alpha-blockers, on the other hand, are typically not used as the first or second addition to a thiazide-type diuretic unless there are specific indications for their use.