The Role of Extracellular Vesicles in the Pathogenesis of Hypertension

Hypertension is one of the most common health problems and a leading global risk factor for cardiovascular, cerebrovascular, and renal diseases. The pathogenesis of essential hypertension is complex, and many organs, such as the heart, kidneys, arteries, and immune system, are involved in its pathophysiology. Extracellular vesicles (EVs) are membrane-bound nanosized structures that are generated and released into the extracellular fluid by all cell types. They mediate cell-to-cell communication in various physiological and pathophysiological processes. Therefore, EVs may play pivotal roles in the pathogenesis and systemic progression of diverse pathological conditions, including inflammatory, vascular, neoplastic, infectious, and neurodegenerative disorders. Emerging evidence has underscored their involvement in the development and progression of hypertension. Circulating and urinary EVs are promising diagnostic, prognostic, and therapeutic biomarkers of cardiovascular diseases, including hypertension. Moreover, EV-mediated therapies, particularly engineered EVs designed for precise drug delivery, are currently being developed for the treatment of various cardiovascular disorders, including hypertension and myocardial infarction. This review explores the role of EVs in the pathogenesis of hypertension and summarizes their potential as diagnostic and prognostic biomarkers.