A previous study has shown that this formula reduced endothelin-1, vascular endothelial growth factor, interleukin (IL)-1β, and tumor necrosis factor (TNF)-α levels, and upregulated nitric oxide synthase (NOS) expression in experimental rats with hypoxia pulmonary hypertension [17, 18], but the underlying mechanisms are still unclear. This evidence concerns the gene TNF and pulmonary arterial hypertension.