The article reviews the potential role of natural antioxidants in addressing endothelial dysfunction associated with arterial hypertension. Arterial hypertension is a leading cause of cardiovascular morbidity and mortality, and the identification of effective treatments for early-stage elevated blood pressure (BP) remains crucial. While traditional antihypertensive drugs have shown significant progress, their effectiveness is limited in about 40% of hypertensive patients due to resistance or the presence of other molecular pathways, such as oxidative stress and inflammation. Natural antioxidants, derived from plant extracts, have emerged as promising solutions to counteract the development of arterial hypertension by enhancing endothelial cell viability and reducing oxidative damage. The review highlights the importance of the endothelium in maintaining normal BP through the production of vasoactive substances like nitric oxide (NO). NO plays a critical role in regulating vascular tone, hemostasis, and angiogenesis, thereby preventing atherosclerosis and thrombosis. However, hypertension is associated with increased free radical levels, which disrupt normal endothelial function. Natural antioxidants can help maintain endothelial health and positively affect blood pressure by reducing oxidative stress and inflammation. The article also discusses the role of exosomes in intercellular communication and their potential as therapeutic targets for endothelium-related disorders. Exosomes transport bioactive molecules and can influence cellular functions, contributing to both beneficial and detrimental processes in the endothelium. Oxidative stress, a multicompartmental phenomenon, is a key factor in the onset and progression of hypertension. Antioxidants, both endogenous and dietary, play a crucial role in preventing and repairing damage caused by reactive oxygen species (ROS). The imbalance between ROS production and antioxidant capacity leads to endothelial dysfunction and hypertension. The review further explores the relationship between oxidative stress and inflammation, emphasizing their synergistic effects in the pathogenesis of arterial hypertension. Microbiota alteration and dietary interventions, such as intermittent fasting, can influence inflammation and substance production, potentially affecting cardiovascular health. Finally, the article provides an overview of antihypertensive therapies, including pharmacological treatments and nutraceuticals. Natural antioxidants and nutraceuticals, such as coenzyme Q10, melatonin, L-arginine, vitamin C, and omega-3 PUFAs, have been shown to be effective in treating mild hypertension and improving endothelial function. These natural compounds can be used as adjunctive therapies to enhance the effectiveness of conventional treatments and reduce the risk of cardiovascular disease and metabolic syndrome.The article reviews the potential role of natural antioxidants in addressing endothelial dysfunction associated with arterial hypertension. Arterial hypertension is a leading cause of cardiovascular morbidity and mortality, and the identification of effective treatments for early-stage elevated blood pressure (BP) remains crucial. While traditional antihypertensive drugs have shown significant progress, their effectiveness is limited in about 40% of hypertensive patients due to resistance or the presence of other molecular pathways, such as oxidative stress and inflammation. Natural antioxidants, derived from plant extracts, have emerged as promising solutions to counteract the development of arterial hypertension by enhancing endothelial cell viability and reducing oxidative damage. The review highlights the importance of the endothelium in maintaining normal BP through the production of vasoactive substances like nitric oxide (NO). NO plays a critical role in regulating vascular tone, hemostasis, and angiogenesis, thereby preventing atherosclerosis and thrombosis. However, hypertension is associated with increased free radical levels, which disrupt normal endothelial function. Natural antioxidants can help maintain endothelial health and positively affect blood pressure by reducing oxidative stress and inflammation. The article also discusses the role of exosomes in intercellular communication and their potential as therapeutic targets for endothelium-related disorders. Exosomes transport bioactive molecules and can influence cellular functions, contributing to both beneficial and detrimental processes in the endothelium. Oxidative stress, a multicompartmental phenomenon, is a key factor in the onset and progression of hypertension. Antioxidants, both endogenous and dietary, play a crucial role in preventing and repairing damage caused by reactive oxygen species (ROS). The imbalance between ROS production and antioxidant capacity leads to endothelial dysfunction and hypertension. The review further explores the relationship between oxidative stress and inflammation, emphasizing their synergistic effects in the pathogenesis of arterial hypertension. Microbiota alteration and dietary interventions, such as intermittent fasting, can influence inflammation and substance production, potentially affecting cardiovascular health. Finally, the article provides an overview of antihypertensive therapies, including pharmacological treatments and nutraceuticals. Natural antioxidants and nutraceuticals, such as coenzyme Q10, melatonin, L-arginine, vitamin C, and omega-3 PUFAs, have been shown to be effective in treating mild hypertension and improving endothelial function. These natural compounds can be used as adjunctive therapies to enhance the effectiveness of conventional treatments and reduce the risk of cardiovascular disease and metabolic syndrome.