The following are my understanding as regards to raised blood pressure. A skinny, tall, fit person can have raised blood pressure and a small, fat, unhealthy person can have normal blood pressure, size, body shape and fitness means nothing.
Raised blood pressure gradually makes your arteries brittle, so in general the doctors are not so concerned with younger persons having strokes as they are with older persons, but they do want to lower your pressures as soon as poss to stop the brittleness developing and this in most cases means medication.
Lifestyle changes can make a difference to your blood pressure, stop smoking, drink less alcohol,( binge drinking is a killer in young and old as it massively raises blood pressure) loose weight, proper diet, de-stress and keep fit, but many people dont want to make those sacrifices so they take medication. Medical conditions can also play a vital role in blood pressure regulation, the kidneys are a major factor, but thats what the blood tests are for.
Shop bought Blood pressure monitors are ok, but allow a discrepancy of about 10 in the readings e.g. reading is 120/60 treat as a poss 130/70 and so on. I have 3 different types and the best one is the Aneroid type. Bear in mind that blood pressures do rise in times of stress, job interview, dentist or first date with a new friend, but it will then fall back to a normal level 140/90 max for a healthy person, 130/80 max for someone with a medical condition e.g. diabetes.
I am 6'1" tall, weigh 14st, big boned, 55yrs, cycle 120-150 mls a week, play golf 3-4 times a week, practise Tai Chi, light weight train, drink in moderation (3 nights off then 3-5 units on the other nights) do not smoke, eat healthy. I have no medical issues yet my blood pressure with medication is generally 110/65 pulse at rest 51 bpm, without meds 150/110+ pulse the same. I started to get severe ache in the back of my neck, thought it was muscle cramp from having a car window down, on the third occasion in 2 weeks I realised it was something else and my G.P. confirmed it was high blood pressure.
If your blood pressure is high for no reason, dont muck about get it treated, as it is not called "the silent killer" for no good reason.