Approximately 80 million US adults have hypertension, and hypertension remains a leading risk factor for stroke and cardiovascular disease.1 In 2009-2010, 48% of treated hypertensive patients in the United States were taking more than 1 drug, and blood pressure remained uncontrolled among 40% of those receiving drug treatment.1 Current guidelines for prevention and treatment of hypertension are based on observational studies in populations and clinical trials in large groups of patients. Precision medicine and epigenetics are 2 emerging and complementary strategies that have the potential to alter clinical approaches to understanding and treating hypertension. Both approaches have the goal of more effective hypertension control by providing personalized targets for preventive and therapeutic interventions.