Hindawi Publishing Corporation Evidence-Based Complementary and Alternative Medicine Volume 2012, Article ID 873210, 9 pages doi:10.1155/2012/873210 Review Article Natural Product Nitric Oxide Chemistry: New Activity of Old Medicines Hong Jiang,1 Ashley C. Torregrossa,1 Deepa K. Parthasarathy,1 and Nathan S. Bryan1, 2 1 Texas Therapeutics Institute, Brown Foundation Institute of Molecular Medicine, The University of Texas Health Science Center at Houston, 1825 Pressler Street, Houston, TX 77030, USA 2 Department of Integrative Biology and Pharmacology, The University of Texas Graduate School of Biomedical Sciences at Houston, The University of Texas Health Science Center at Houston, 1825 Pressler Street, Houston, TX 77030, USA Correspondence should be addressed to Nathan S. Bryan, nathan.bryan@uth.tmc.edu Received 14 October 2011; Accepted 19 January 2012 Academic Editor: Ka Kit Hui Copyright © 2012 Hong Jiang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The use of complementary and alternative medicine (CAM) as a therapy and preventative care measure for cardiovascular diseases (CVD) may prove to be beneﬁcial when used in conjunction with or in place of conventional medicine. However, the lack of understanding of a mechanism of action of many CAMs limits their use and acceptance in western medicine. We have recently recognized and characterized speciﬁc nitric oxide (NO) activity of select alternative and herbal medicines that may account for many of their reported health beneﬁts. The ability of certain CAM to restore NO homeostasis both through enhancing endothelial production of NO and by providing a system for reducing nitrate and nitrite to NO as a compensatory pathway for repleting NO bioavailability may prove to be a safe and cost-eﬀective strategy for combating CVD. We will review the current state of science behind NO activity of herbal medicines and their eﬀects on CVD. 1. Introduction Complementary and alternative medicine (CAM) is the term for medical products and practices that are not a part of stan- dard care. There is generally a lack of understanding of their mechanisms of action and/or the active compounds. Rigor- ous, well-designed clinical trials for many CAM therapies are often lacking; therefore, the safety and eﬀectiveness of many of these types of therapies are uncertain and as a result are not recognized as mainstream therapy. However, Traditional Chinese Medicine (TCM) is a form of CAM that remains the primary form of medicine throughout a large portion of Asia and Asian communities in the rest of world with a long history of safety and eﬃcacy in a number of diﬀerent diseases. In fact, one could argue that TCM is the earliest form of CAM. Deﬁning CAM here in the USA is diﬃcult because the ﬁeld is very broad and constantly changing. The National Institutes of Health now has a dedicated Center for Complementary and Alternative Medicine (NCCAM) due to the growing popularity of such approaches to ensure safety and promote rigorous clinical trials to demonstrate eﬃcacy. NCCAM deﬁnes CAM as a group of diverse medical and health care systems, practices, and products that are not gen- erally considered part of conventional medicine, as practiced by medical doctors and their allied health professionals. The boundaries between CAM and conventional medicine are not absolute, and speciﬁc CAM practices may, over time, become widely accepted. Complementary medicine refers to use of alternative treatments together with conventional medicine, such as using acupuncture or herbal medicines in addition to usual care to help with disease management. Most use of CAM by Americans is complementary. Alterna- tive medicine refers to use of CAM in place of conventional medicine. Integrative medicine combines treatments from conventional medicine and CAM for which there is some high-quality evidence of safety and eﬀectiveness. It is also called integrated medicine. Since many CAM-based thera- pies are derived from TCM, we will provide a brief historical account behind the theory of TCM, and how this has now been integrated into CAM approaches here in the USA. TCM has long been used as a major health care system in China and many other countries in Asia. Here in the USA, it