Epigenetic phenomena are defined as heritable mechanisms that establish and 
maintain mitotically stable patterns of gene expression without modifying the 
base sequence of DNA. The major epigenetic features of mammalian cells include 
DNA methylation, post-translational histone modifications and RNA-based 
mechanisms including those controlled by small non-coding RNAs (miRNAs). The 
impact of epigenetic mechanisms in cardiovascular pathophysiology is now 
emerging as a major player in the interface between genotype to phenotype 
variability. This topic of research has strict implications on disease 
development and progression, and opens up possible novel preventive strategies 
in cardiovascular disease. An important aspect of epigenetic mechanisms is that 
they are potentially reversible and may be influenced by 
nutritional-environmental factors and through gene-environment interactions, all 
of which have an important role in complex, multifactorial diseases such as 
those affecting the cardiovascular system. Gene expression regulation through 
the interplay of DNA methylation and histone modifications is well-established, 
although the knowledge about the function of epigenetic signatures in 
cardiovascular disease is still largely unexplored. The study of epigenetic 
markers is, therefore, a very promising frontier of science which may aid in a 
deeper understanding of molecular mechanisms underlying the modulation of gene 
expression in the biomolecule pathways linked to cardiovascular diseases. This 
review focuses on up-to-date knowledge pertaining to the role of epigenetics, 
from DNA methylation to miRNAs, in major cardiovascular diseases such as 
ischemic heart disease, hypertension, heart failure and stroke.