CYP4F2 encodes a cytochrome P450 monooxygenase that catalyzes omega-oxidation of fatty acids, eicosanoids, and vitamins using molecular oxygen and NADPH 1. The enzyme plays a critical role in arachidonic acid metabolism, converting it to 20-HETE, a signaling molecule that regulates vascular tone and blood pressure 2. CYP4F2 also metabolizes vitamin K1 and vitamin K2, making it clinically significant for warfarin dosing, as genetic variants affect vitamin K metabolism and consequently anticoagulant drug requirements 3. The most studied polymorphism, CYP4F2*3 (V433M), reduces enzyme activity and is associated with higher warfarin dose requirements, with T carriers needing 11% higher doses compared to wild-type 4. Computational analysis reveals this variant destabilizes the protein structure and reduces binding affinity for vitamin K1 5. Additionally, CYP4F2 polymorphisms show associations with hypertension risk, with rs1558139 and rs2108622 variants demonstrating protective effects in meta-analyses 6. The enzyme's role in 20-HETE production creates complex effects on blood pressure regulation, as both elevated and deficient 20-HETE levels have been linked to hypertension 2. CYP4F2 variants are incorporated into pharmacogenetic guidelines for warfarin dosing in both adult and pediatric populations 3.