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However, at high concentrations, when RNS levels exceed the capability of its detoxification in the biological system, serious damage to cells may occur [147, 148] due to inhibition of mitochondrial respiratory function by competing with O 2 for interaction with cytochrome oxidase [149] and via nitrative/nitrosative stress [150, 151]

10.1016/j.phymed.2024.155554 Summary Keywords Chinese medicine, natural metabolites, CVDs, flavonoids, alkaloids, saponins Citation Liu X, Zhang W, Miao X and Hu Y (2025) Natural metabolites used in traditional Chinese medicine for cardiovascular diseases: pharmacological mechanisms, evidence, and future directions