If you are one of the smaller number of people at high risk of heart disease with these systolic readings, medications in addition to a healthy lifestyle are beneficial. The blood pressure target should be individualised and based on your risk profile and preferences. You might discuss with your doctor ways to help make sure you take the medication.
If you are in between these two extremes, the benefits and harms of diagnosis are in rough balance. Some people are willing to adopt or continue a healthy lifestyle and accept a moderate increase in the risk of a heart event to avoid taking daily medications, increased doses or more medications, and others are not. In this situation, informed and shared decision-making between you and your doctor is essential.