It is estimated that 200 million adults in sub-Saharan Africa are already living with, and at elevated risk of dying from, elevated blood pressure or hypertension. This reflects reports that more than a third of adults in the region are hypertensive.1 Although the numbers might seem overwhelming, it is crucial to identify what needs to change to protect future generations. This means examining the blood pressure profiles and possible progression to cardiovascular disease and premature mortality linked to hypertension among young adults living in sub-Saharan Africa. Accordingly, in The Lancet Child & Adolescent Health, Kalpana Sabapathy and colleagues2 report on the prevalence of hypertension (defined as systolic blood pressure of ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg) among a randomly selected cohort of 16 883 individuals aged 18–24 years from 24 urban and peri-urban communities across Zimbabwe—a southern African, low-to-middle-income country of approximately 16 million people. Overall, Sabapathy and colleagues2 report a prevalence of hypertension of 7·4% (95% CI 7·0–7·8) and a prevalence of high-normal blood pressure of 12·2% (11·7–12·7). Although more men were hypertensive overall, this differential steadily disappeared with increasing age; the prevalence of hypertension at age 23–24 years was 9·5% (95% CI 8·4–10·7) among women and 10·9% (9·3–12·6) among men.2 These data are consistent with a systematic review and meta-analysis of blood pressure among 52 918 adolescents aged 10–19 years derived from ten of 49 countries in sub-Saharan Africa.3 That meta-analysis suggested an overall prevalence of elevated blood pressure of 9·9% (95% CI 7·3–12·5).3 Both the meta-analysis and Sabapathy and colleagues' study, which together examine blood pressure across a contiguous age cohort from age 10 to 24 years, show that the prevalence of hypertension steadily rises with increasing age, with sex and BMI being important modulators.