Vascular smooth muscle cells (VSMCs) are one of the main cell types that constitute the vascular wall and play an important role in the development of cardiovascular diseases (CVDs). Normally, VSMCs are primarily involved in regulating vascular tone. Under pathological conditions, their phenotypic switching from a contractile to a pathological phenotype occurs, which is accompanied by impaired contractile function. These disorders lead to the development of different CVDs. In this regard, the aim of this review was to assess the influence of the features of differentiation pathways of VSMCs from embryonic progenitor cells and various transcription factors on the development of CVDs. Primary attention is given to the mechanisms of phenotypic switching of VSMCs, which plays a key role in the pathogenesis of vascular disorders. Particular emphasis is placed on investigating the effect of microRNAs (miRs) on the functional state of VSMCs. The analysis of current data demonstrates that alterations in miR expression result in significant functional rearrangements of VSMCs, which can contribute to the progression of CVDs. Consequently, understanding the mechanisms of VSMC dysfunction presents promising opportunities for developing targeted therapies aimed at restoring normal vascular wall function and preventing the development of CVDs.

The achievements of regenerative medicine are based on methods of controlling stem cell division and differentiation. Electromagnetic fields stimulate cell differentiation by means of affecting calcium channels and cellular signaling. However, only a small part of the mechanisms underlying electromagnetic field effect on cells has been studied. The prospect of their use in tissue engineering as an addition or alternative to biochemical effects becomes clear in the course of numerous experiments. Electromagnetic stimulation enhances the effect of biochemical differentiation inducers and can cause the secretion of exosomes of special properties, which may serve as a therapeutic tool. For example, it has been shown that EMFs at 15 Hz and 2 mT increased the expression of chondrogenic differentiation markers SOX9 and COL2 in human bone-marrow MSCs by up to 3-fold (based on Parate et al.). Optimizing EMF parameters (e.g., 15–50 Hz, 1–2 mT) for specific cells and pathologies remains a key challenge of the studies in the field of tissue engineering. This review describes the electromagnetic field effect on the chondrogenic and osteogenic differentiation of MSCs of various origins, which is important for the musculoskeletal tissue recovery, as well as on inflammatory diseases in model animals.