Younger adults (ages ≤50 years) are increasingly prone to stroke, chronic kidney disease (CKD), and worsening cardiovascular disease (CVD) mortality in the US. An alarming increase in prevalence of high blood pressure (BP) related to the obesity epidemic appears to underlie these adverse trends. However, what specific BP characteristics measured in young adulthood optimally predict incident CVD and CKD later in life remains to be determined. Therefore, an optimization of diagnostic and therapeutic strategies in BP management for young adults is challenging but essential. In my lecture, I will fill the gap, using results from the Coronary Artery Risk Development in Young Adults (CARDIA) Study.