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Young U.S. adults are at increased risk for cardiovascular disease. Researchers in the March 21 JAMA examined the prevalence, treatment, and control of cardiovascular disease risk factors in close to 13,000 adults ages 20 to 44 years from 2009 to 2020. While the overall prevalence of hypertension remained constant, the prevalence of diabetes and obesity increased, specifically in Black and Hispanic adults. The only improvement was in the prevalence of hyperlipidemia, which decreased from 40.5% to 36.1%. There were no significant improvements in treatment or control rates, such as trends in blood pressure measurements or in glycated hemoglobin levels. As noted in an accompanying editorial, these results call for vigorous health promotion strategies to reverse these trends before they lead to increased inequities in cardiovascular health and early morbidity and mortality.