The Future of Genetics and Genomics

In this forward-facing review, we briefly summarize what we see as the state of modern cardiovascular genetics and genomics before outlining some of the key areas in which we believe there is a need for investment if we are to realize the full clinical potential of the field. There is clearly substantial overlap with the field of precision medicine, yet it may be in understanding where genetics and genomics currently fall short that we will identify how precision medicine might move forward. The recognition over the last decade that genetics or genomics alone is unlikely to offer the predictive utility necessary for precision medicine is matched by our dependence on genetics and genomics for much of the mechanistic insight necessary to achieve precision diagnostics or precision therapeutics. The overarching strategies we discuss emphasize that the future of cardiovascular genetics and genomics is inextricably linked with those of every other field of medicine. We must move beyond the silos of traditional organ-based disease if we are to realize fully the need for generalizable biological rules that constitute the truly mechanistic medicine or molecular medicine first envisaged >40 years ago.