Top Things to Know: Clonal Hematopoiesis and Its Cardiovascular Implications
Published: February 10, 2026
Prepared by Paul St. Laurent, RN, DNP
- Clonal hematopoiesis (CH), the benign expansion of hematopoietic stem cell clones due to somatic mutations, is increasingly prevalent with age and is linked to higher risk for atherosclerosis, heart failure, atrial fibrillation, and thrombosis.
- The cardiovascular (CV) risk associated with CH varies by specific mutated genes, clone size, and extrinsic factors. Not all CH mutations confer the same level of risk.
- CH promotes CVD disease through gene-specific and general inflammatory pathways, including cytokine overproduction and inflammasome activation, which accelerate atherosclerosis and impair vascular and myocardial function.
- Germline genetic predisposition, exposure to toxins such as chemotherapy, radiation, and smoking, and chronic inflammation from obesity, sleep deprivation, HIV, and premature menopause, increase the risk of developing CH.
- Mutations in genes like DNMT3A, TET2, ASXL1, and JAK2 have distinct impacts on CV outcomes. For example, TET2 mutations are strongly linked to increased inflammation and CVD risk, while JAK2 mutations are associated with thrombosis.
- CH carriers have higher rates of coronary artery disease, myocardial infarction, heart failure, stroke, and peripheral artery disease, and tend to have worse outcomes after CV events.
- CH is often detected incidentally during genetic testing for other conditions. Risk stratification tools are being developed, but clinical management is still evolving.
- No proven therapies exist yet for CH-associated CVD, however, experimental approaches include treatments that target inflammation and restore gene function.
- “CHIP Clinics” are emerging for the multidisciplinary management of CH, focusing on both hematologic malignancy and CV risk. A holistic approach can be effective due to CH’s broad health implications.
- Integrating CH status into CVD risk prediction models may enable more personalized prevention and treatment. Longitudinal studies and clinical trials are needed to clarify causal mechanisms and test interventions.
Citation
Rhee J-W, Bolton KL, Gupta D, Weeks LD, Bick AG, Tall AR, Walsh K, Fuster JJ, Natarajan P; on behalf of the American Heart Association Molecular Determinants of Cardiovascular Health Committee of the Council on Genomic and Precision Medicine and Council on Epidemiology and Prevention; and the Cardio-Oncology Committee of the Council on Clinical Cardiology and Council on Epidemiology and Prevention. Clonal hematopoiesis and its cardiovascular implications: a scientific statement from the American Heart Association. Circulation. Published online February 10, 2026. doi: 10.1161//CIR.0000000000001404