The positive correlation of angiotensin-converting enzyme (ACE) polymorphism with HCM has been well studied [3]. In addition to this, various modifiable risk factors such as hypertension, physical activity, and non-modifiable risk factors such as gender have been studied to explore further the penetrance and severity of phenotypic expression in a population with genetic mutation developed HCM [4]. Along with the genetic, demographic, environmental, and comorbid factors, it is important to note that epigenetics has its place in the pathophysiology of this disease. This evidence concerns the gene ACE and Hypertension.