Cardiovascular diseases (CVDs) remain the leading cause of death and disability worldwide, highlighting an urgent need for new treatments. Traditional Chinese Medicine (TCM) offers a rich repository of natural metabolites (flavonoids, alkaloids, saponins, etc.) that act on multiple targets to protect the heart and blood vessels. These compounds have demonstrated multiple cardioprotective effects, including anti-inflammatory, antioxidant, anti-atherosclerotic, and blood pressure–lowering activities. They work by reducing oxidative stress, dampening chronic inflammation, improving blood vessel function, correcting abnormal lipid levels, and mitigating cardiac fibrosis. Recent preclinical studies and clinical trials show that TCM-derived metabolites can improve cardiovascular health. For instance, the multi-herb formula Qili Qiangxin and the alkaloid berberine have improved heart failure symptoms and cardiac function in clinical trials when added to standard therapy. These examples underscore the clinical potential of TCM compounds. However, challenges like poor bioavailability, complex multi-component interactions, and lack of standardization still hinder their widespread use. To address these issues, researchers are exploring advanced drug delivery methods and better quality control with modern analytical tools. If these hurdles are overcome, TCM-derived therapies could be successfully integrated into mainstream cardiovascular care, offering a novel multi-target approach to combat CVDs.

In traditional Chinese medicine, acupuncture is considered free of harmful side effects when properly performed. Pharmacokinetics provides a valuable approach to explore how acupuncture influences drug disposition. Stimulation at specific acupoints, such as Zusanli (ST36), may modulate drug absorption and action. While most studies highlight beneficial outcomes, potential risks also deserve consideration. A systematic review was conducted to evaluate how acupuncture or electroacupuncture at ST36 affects the pharmacokinetics of various drugs. Data on changes in absorption, distribution, metabolism, and excretion, along with pharmacokinetic parameters (e.g., average plasma concentration-time curve [AUC], C _max , T _max ), were extracted and analyzed. Acupuncture at ST36 significantly influenced the pharmacokinetics of several compounds. For instance, it enhanced the absorption and plasma levels of Schisandra chinensis lignans and acetaminophen (APAP), increasing AUC and C _max while shortening T _max . Tissue distribution also shifted, with elevated concentrations observed in certain organs such as the lungs. While aspirin metabolism remained unaffected, ST36 stimulation delayed APAP clearance at higher doses, resulting in prolonged systemic exposure. In the case of triptolide, a bioactive diterpenoid, acupuncture increased its plasma levels and AUC. Some studies reported changes in biomarkers associated with liver function under elevated compound exposure, though no acute adverse effects were noted for commonly used agents. ST36 acupuncture can alter drug pharmacokinetics, potentially impacting drug exposure and clinical response. Awareness of such interactions is important when combining acupuncture with medication. Further studies are warranted to ensure the safe and effective integration of acupuncture into pharmacological treatment strategies.