A related commentary discusses this research. Major gaps exist in current knowledge regarding the epidemiology, diagnosis, risk stratification, and management of higher blood pressure levels in young adults. Studies are needed to elucidate the developmental origins of higher blood pressure levels in children and the impact of social determinants of health, on blood pressure trajectories in youth. Greater clarity is needed regarding the potential use of individual characteristics (eg, geographic residence in the stroke belt, black race with apolipoprotein L1 risk alleles, or a positive family history of CVD), long-term CVD risk, and blood pressure–mediated target organ damage to guide treatment decisions for high blood pressure levels in young adults.