Introduction
The cardiovascular system plays a crucial role in maintaining homeostasis and ensuring the efficient circulation of blood throughout the body.
Several studies showed that dysfunction within this system can result in a spectrum of cardiovascular diseases (CVDs),
including atherosclerosis, hyperlipidemia, and hypertension [1,2,3,4].
Hypertension, which is a prevalent cardiovascular condition, necessitates ongoing exploration of diverse interventions to manage its impact on global health.
Amidst the pharmacological interventions available, there is growing interest in exploring natural remedies,
with garlic emerging as a promising candidate [5]. Garlic is the edible bulb from a plant in the lily family, and it is renowned for its culinary uses and traditional medicinal properties.
It has long been associated with various health benefits due to its bioactive compounds, such as sulfur-containing compounds, ajoene, alliin, and allicin [6].
The main bioactive chemical constituents in garlic are organosulfur compounds.
Alliin is a precursor to other bioactive chemicals. Alliinase hydrolyzes dehydroalanine to produce allyl sulfenic acid.
Allicin reduces oxidative stress, enhances mitochondrial function, and influences CVD risk factors [7,8].
2-Vinyl-4H-1,3-dithiin has anti-proliferative and anti-migratory properties. Diallyl sulfide (DAS), diallyl disulfide (DADS), diallyl trisulfide (DATS), and allyl methyl sulfide (AMS) all contribute to garlic’s health benefits [7].
Garlic lowers blood pressure by a synchronized interplay of biochemical and physiological mechanisms.
While the exact pathways are not fully explained, several key mechanisms were proposed based on research findings. Some of the proposed pathophysiologies include vasodilation via nitric oxide (NO) release,
enhanced endothelial function, antioxidant properties, inhibition of angiotensin converting enzyme (ACE) activity, sodium and water excretion, and anti-inflammatory effects [9].
Alliin reduces blood triglycerides, boosts HDL cholesterol, and inhibits myocardial lipid accumulation.
Allicin prevents vascular calcification, promotes endothelial cell migration, and lowers blood pressure and plasma lipids.
AMS lowers fetal gene expression and protects against oxidative stress [7].
It is important to highlight that the efficacy of garlic in lowering blood pressure can vary based on diverse factors such as the type of garlic used (fresh, aged extract, supplements), individual responses, and dosage [10].
This narrative review aimed to investigate the effectiveness of garlic in improving hypertension, with a specific focus on its constituent phytochemicals and their modes of action.
It focused on articles published between 2014 and 2024 that were sourced from PubMed. The scope included randomized controlled trials, clinical trials, meta-analyses, and systematic reviews, with some exceptions for particularly relevant studies outside this timeframe. Excluded from this review were studies that focused on other cardiovascular conditions.
2. Historical Use of Garlic in Traditional Medicine
Throughout history, many cultures have used garlic for medicinal purposes, particularly in relation to the heart and blood pressure.
In ancient Egypt, the Ebers Papyrus prescribed garlic for heart-related issues. It was also implemented in treating tumors, abscesses, malaise, and parasitic or insect infestations [11].
In Greece and Rome, garlic was used to “cleanse the arteries” and linked to cardiovascular health by figures like Hippocrates and Dioscorides [11]. Charaka, the father of Ayurvedic medicine from 3000 B.C., claimed that “garlic maintains the fluidity of blood and strengthens the heart” [12]. In India, Ayurvedic medicine uses garlic to maintain blood fluidity and strengthen the heart.
Garlic is now well known to reduce blood pressure if used appropriately [13]
and a diuretic effect was attributed to it, where it is believed that the mobilization of fluid from the extravascular space results in improved cardiovascular function due to garlic treatment.
Furthermore, it was thought to improve elevated serum cholesterol, decrease the aggregation of platelets, and protect the vascular endothelium from damage by LDL
Ref
Nutrients. 2024 Aug 29;16(17):2895. doi: 10.3390/nu16172895
Garlic and Hypertension: Efficacy, Mechanism of Action, and Clinical Implications
Christopher Sleiman 1, Rose-Mary Daou 1, Antonio Al Hazzouri 1, Zahi Hamdan 1, Hilda E Ghadieh 1, Bernard Harbieh 1,*, Maya Romani 2,*
Editors: Kenneth Ka-Hei Lo, Aimin Yang
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