It has also been reported that through the P21-activated kinase 1 (Pak1)-dependent signaling pathway, BBR (3 mg/kg/d) might suppress the upregulation of Smad3-mediated muscle-specific F-box protein (Fbxo32) in downstream promoter region and take part in the inhibition of myocardial hypertrophy (Tsui et al., 2015). This evidence concerns the gene PAK1 and cardiac hypertrophy.