Reply to comment on 'Epigenetics and cardiovascular risk in childhood'.

To the Editor We have read with great interest the recently published review by Martino et al. which addresses the importance of the interaction between genetic (hereditary) and epigenetic (environmental) factors in influencing the future cardiovascular destiny of the involved patients during the vulnerable period of embryonic development. The authors have in depth examined a number of metabolic pathways leading to reprograming of fetal genome targets. Several factors (reproductive techniques, parents’ diet, mother’s hypercholesterolemia and smoking, and environmental pollution) are able to induce an early atherosclerotic process in the product of conception. In addition, miRNA-based targeted therapies as well as some changes in mother’s behavior look likely to be able to reverse the increased cardiovascular risk in these children. The review of Martino et al., in accordance with our research, focused on the influence of low birth weight, intrauterine growth restriction, and decreased gestational age in increasing susceptibility to atherosclerosis, supraventricular and ventricular arrhythmias, hypertension, and cardio-renal syndrome.