Despite advances in the prevention and management of cardiovascular disease 
(CVD), this group of multifactorial disorders remains a leading cause of 
mortality worldwide. CVD is associated with multiple genetic and modifiable risk 
factors; however, known environmental and genetic influences can only explain a 
small part of the variability in CVD risk, which is a major obstacle for its 
prevention and treatment. A more thorough understanding of the factors that 
contribute to CVD is, therefore, needed to develop more efficacious and 
cost-effective therapy. Application of the 'omics' technologies will hopefully 
make these advances a reality. Epigenomics has emerged as one of the most 
promising areas that will address some of the gaps in our current knowledge of 
the interaction between nature and nurture in the development of CVD. Epigenetic 
mechanisms include DNA methylation, histone modification, and microRNA 
alterations, which collectively enable the cell to respond quickly to 
environmental changes. A number of CVD risk factors, such as nutrition, smoking, 
pollution, stress, and the circadian rhythm, have been associated with 
modification of epigenetic marks. Further examination of these mechanisms may 
lead to earlier prevention and novel therapy for CVD.