Precision medicine is transforming cardiovascular research, but not always in the ways many expect. While inherited cardiomyopathies, channelopathies, and AI-assisted diagnostics are already delivering measurable clinical value, the application of precision approaches to common cardiovascular diseases remains a work in progress. This whitepaper examines where the evidence is strongest today, where the greatest opportunities lie for the coming decade, and which scientific and methodological challenges still need to be addressed to turn potential into patient benefit.