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A high systolic blood pressure has been associated with an increase of cardiovascular complications such as stroke and heart attack, even if the diastolic is normal.  In fact, a recently published guideline on hypertension classifies a systolic blood pressure (BP) over 140 OR a diastolic BP over 90 as stage 1 hypertension.  The first way to treat high blood pressure is to make some important lifestyle modifications including changes in diet, increased physical activity, and weight loss.  If that fails then medications are recommended.