CYP4A11 is a cytochrome P450 monooxygenase that catalyzes omega-oxidation of fatty acids and arachidonic acid metabolites 1. The enzyme uses molecular oxygen to insert one oxygen atom into substrates while reducing the second to water, with electrons supplied by NADPH via cytochrome P450 reductase 1. CYP4A11 preferentially oxidizes the terminal carbon of saturated and unsaturated fatty acids, with highest catalytic efficiency toward dodecanoic acid, serving as the major hepatic omega-hydroxylase for this substrate 1. A critical physiological function involves metabolizing arachidonic acid to 20-hydroxyeicosatetraenoic acid (20-HETE), a signaling molecule that regulates renal function and vascular tone with both vasoconstrictive and natriuretic properties affecting blood pressure 1. CYP4A11 may contribute to degradation of very long-chain fatty acids through successive omega-oxidations and catalyzes omega-hydroxylation of epoxy-octadecanoate 1. Genetically, the T8590C polymorphism is associated with essential hypertension risk, particularly in Caucasian populations, with meta-analyses showing increased hypertension risk in C allele carriers 23. Additional CYP4A11 variants (rs1126742, rs3890011, rs9333025) demonstrate gene-gene and gene-environment interactions influencing hypertension and ischemic stroke susceptibility 456. The rs9333025 GG genotype associates with cerebral infarction risk in Japanese men 6.