Peroxisome proliferator-activated receptors (PPARs) play vital roles in cardiovascular pathophysiology, such as energy balance, cell proliferation/apoptosis, inflammatory response, and adipocyte differentiation. These vital roles make PPARs potential targets for therapeutic prevention of
cardiovascular diseases (CVDs). Emerging evidence indicates that the crosstalk of
microRNAs (
miRNAs) and PPARs contributes greatly to CVD pathogenesis. PPARs are inhibited by
miRNAs at posttranscriptional mechanisms in the progress of
pulmonary hypertension and vascular dysfunction involving cell proliferation/apoptosis, communication, and normal function of endothelial cells and vascular smooth muscle cells. In the development of
atherosclerosis and
stroke, the activation of PPARs could change the transcripts of target
miRNA through
miRNA signalling. Furthermore, the mutual regulation of PPARs and
miRNAs involves cell proliferation/apoptosis, cardiac remodeling, and dysfunction in
heart diseases. In addition,
obesity, an important cardiovascular risk, is modulated by the regulatory axis of PPARs/
miRNAs, including adipogenesis, adipocyte dysfunction,
insulin resistance, and macrophage polarization in adipose tissue. In this review, the crosstalk of PPARs and
miRNAs and their emerging regulatory roles are summarized in the context of CVDs and risks. This provides an understanding of the underlying mechanism of the biological process related to CVD pathophysiology involving the interaction of PPARs and
miRNAs and will lead to the development of PPARs/
miRNAs as effective anti-CVD medications.