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Arterial hypertension (AH) is a complex, multifactorial pathology, constituting one of the main risk factors for cardiovascular diseases such as myocardial infarction, stroke and heart failure. It results from dynamic interactions between genetic, environmental and epigenetic factors, which together modulate blood pressure regulation. Among these mechanisms, epigenetic alterations, notably DNA methylation, histone modifications and activation or repression of non-coding RNAs, play a key role in the pathophysiology of hypertension.Recent advances in epigenetics and molecular cardiology are paving the way for innovative approaches offering promising prospects for more personalized management via targeted therapies. This will improve the diagnosis, prevention and treatment of hypertension, while reducing its long-term consequences.