Suboptimal intrauterine development has been linked to predisposition
to cardiovascular disease in adulthood, a concept termed ‘developmental
origins of health and disease’. Although the exact mechanisms underlying
this developmental programming are unknown, a growing body of
evidence supports the involvement of epigenetic regulation. Epigenetic
mechanisms such as DNA methylation, histone modifications and
micro-RNA confer added levels of gene regulation without altering DNA
sequences. These modifications are relatively stable signals, offering
possible insight into the mechanisms underlying developmental origins
of health and disease. This review will discuss the role of epigenetic
mechanisms in heart development as well as aberrant epigenetic
regulation contributing to cardiovascular disease. Additionally, we will
address recent advances targeting epigenetic mechanisms as potential
therapeutic approaches to cardiovascular disease.