**6. Conclusions and perspectives**

CVD seem to begin as a consequence of a damaging process and endothelial dysfunction, and there are pieces of evidence implying cellular senescence in the functional imbalance of the endothelium. Cellular senescence is a physiological mechanism which occurs as a consequence of aging, but

**Figure 3.** Different characteristics of young and senescent endothelial cells. Senescent cells undergo distinctive phenotypic, morphological alterations and senescence-associated secretory phenotype (SASP). The number of endothelial microvesicles (EMVs) of the senescent cells is greater than those derived from young cells. Also, the reactive oxygen species (ROS) production is higher in senescent endothelial cells compared with young endothelial cells. Moreover, the secretion of growth factors (GF) and proinflammatory cytokines (infl. cytokines) from senescent endothelial cells are reduced.

under different pathologic conditions, its regulation is modified, as in CVD or CKD. Senescent endothelial cells change their morphological and functional characteristics (**Figure 3**) and cannot correctly regulate the repairing and regenerative activity of EPCs. In the endothelial senescence context, the role of EMVs appears to be important. EMVs are considered as biomarkers of endothelial injury and are associated with an inflammatory and prothrombotic state. However, the perspectives of their study are beyond their role as biomarkers, as they are capable of transmitting biologic information in several physiologic and physiopathologic processes. EMVs are increased in elderly, but also in patients with CVD and CKD. Many questions remain unresolved to understand the role of EMVs in the endothelial function and damage. To comprehend and characterize the mechanisms by which the senescent endothelial cells show an imbalanced functionality is of great interest, opening new perspectives to increase our knowledge and to identify useful biomarkers in the timely diagnostics and to design therapeutic objectives in CVD.
