Pharmacological therapies, lifestyle choices and nitric oxide deficiency: a perfect storm

Over the past 10 years, despite a slight increase in life expectancy and a decrease in all causes of deaths, the percentage of the US population with heart disease, cancer, diabetes, hypertension and obesity has increased. So even though Americans are living longer, they are plagued by increasing incidences of morbidities. This trend is also reflective of the global population, where 17.3 million people died from cardiovascular disease in 2008, and an estimated 23.6 million are expected to die from this disease in 2030. Whereas access to medical care and management of certain diseases has improved, it is clear that the incidence and treatment of chronic disease has not kept pace. The discovery of nitric oxide (NO) production in the human body is a relatively new advancement of modern medicine. Unfortunately, NO is still not at the forefront of therapy. In the clinical setting, there are no standard laboratory diagnostics for NO status and no prescription therapies to safely and effectively restore NO homeostasis, despite being recognized as the earliest indicator for a number of different chronic diseases. This review will reveal how many modern therapies and western lifestyles actually lead to a decrease in NO homeostasis in patients, from pediatrics to geriatrics. The findings outlined here highlight why nitric oxide homeostasis should be accounted for and considered in the treatment of patients and in the development of new therapies. Understanding NO homeostasis in each patient and how treatments and procedures affect NO homeostasis should allow for better medical care and improved outcomes.