Garlic Shows Promise for Improving Some Cardiovascular Risk Factors
Abstract
OBJECTIVES: To summarize the effects of garlic on several cardiovascular-related factors and to note its adverse effects. METHODS: English and non-English citations were identified from 11 electronic databases, references, manufacturers, and experts from January 1966 through February 2000 (depending on the database searched). Reports of cardiovascular-related effects were limited to randomized controlled trials lasting at least 4 weeks. Reports of adverse effects were not limited by study design. From 1798 pertinent records, 45 randomized trials and 73 additional studies reporting adverse events were identified. Two physicians abstracted outcomes and assessed adequacy of randomization, blinding, and handling of dropouts. Standardized mean differences of lipid outcomes from placebo-controlled trials were adjusted for baseline differences and pooled using random effects methods. RESULTS: Compared with placebo, garlic preparations may lead to small reductions in the total cholesterol level at 1 month (range of average pooled reductions, 0.03-0.45 mmol/L [1.2-17.3 mg/dL]) and at 3 months (range of average pooled reductions 0.32-0.66 mmol/L [12.4-25.4 mg/dL]), but not at 6 months. Changes in low-density lipoprotein levels and triglyceride levels paralleled total cholesterol level results; no statistically significant changes in high-density lipoprotein levels were observed. Trials also reported significant reductions in platelet aggregation and mixed effects on blood pressure outcomes. No effects on glycemic-related outcomes were found. Proven adverse effects included malodorous breath and body odor. Other unproven effects included flatulence, esophageal and abdominal pain, allergic reactions, and bleeding. CONCLUSIONS: Trials suggest possible small short-term benefits of garlic on some lipid and antiplatelet factors, insignificant effects on blood pressure, and no effect on glucose levels. Conclusions regarding clinical significance are limited by the marginal quality and short duration of many trials and by the unpredictable release and inadequate definition of active constituents in study preparations.
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In a large trial in China, red yeast rice supplementation reduced the risk of CHD (31.0%), all-cause mortality (31.9%), stroke (44.1%), need for coronary artery bypass graft or percutaneous coronary intervention (48.6%), and malignancies (51.4%).
“RYR supplementation showed a reduction in the risk of CHD (31.0%, p = 0.04), all-cause mortality (31.9%, p = 0.01), stroke (44.1%, p = 0.04), the need for coronary artery bypass graft or a percutaneous coronary intervention (48.6%, p = 0.07), and malignancies (51.4%, p = 0.03).”
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Cites
Wasserman, S. S., Hedges, L. V., & Olkin, I. (1988) · Journal of Educational Statistics · doi:10.2307/1164953 · Cited by 10,347 · see citing works
Trends in Alternative Medicine Use in the United States, 1990-1997
Eisenberg, D. M., Davis, R. B., Ettner, S. L., Appel, S., Wilkey, S. A., Rompay, M. I. V., & Kessler, R. C. (1998) · JAMA · doi:10.1001/jama.280.18.1569 · Cited by 6,693 · see citing works
Meta-analysis: Principles and procedures
Egger, M., Smith, G. D., & Phillips, A. N. (1997) · BMJ · doi:10.1136/bmj.315.7121.1533 · Cited by 2,415 · see citing works
The Hazards of Scoring the Quality of Clinical Trials for Meta-analysis
Jüni, P. (1999) · JAMA · doi:10.1001/jama.282.11.1054 · Cited by 1,981 · see citing works
<i>meta-analysis</i> bias in location and selection of studies
Egger, M., & Smith, G. D. (1998) · BMJ · doi:10.1136/bmj.316.7124.61 · Cited by 1,374 · see citing works
The Powerful Placebo Effect: Fact or Fiction?
Kienle, G. S., & Kiene, H. (1997) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(97)00203-5 · Cited by 409 · see citing works
Concept of true and perceived placebo effects
Ernst, E., & Resch, K. (1995) · BMJ · doi:10.1136/bmj.311.7004.551 · Cited by 407 · see citing works
Effect of Garlic on Total Serum Cholesterol
Warshafsky, S., Kamer, R. S., & Sivak, S. L. (1993) · Annals of Internal Medicine · doi:10.7326/0003-4819-119-7_part_1-199310010-00009 · Cited by 372 · see citing works
A meta-analysis of the effect of garlic on blood pressure
Silagy, C., & Neil, H. A. W. (1994) · Journal of Hypertension · doi:10.1097/00004872-199404000-00017 · Cited by 340 · see citing works
Steiner, M., Khan, A., Holbert, D., & Lin, R. (1996) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/64.6.866 · Cited by 283 · see citing works
Garlic as a Lipid Lowering Agent—A Meta-Analysis
Silagy, C., & Neil, A. (1994) · Journal of the Royal College of Physicians of London · doi:10.1016/s0035-8819(25)00866-9 · Cited by 261 · see citing works
Bordia, A., Verma, S. K., & Srivastava, K. C. (1998) · Prostaglandins Leukotrienes and Essential Fatty Acids · doi:10.1016/s0952-3278(98)90034-5 · Cited by 249 · see citing works
Block, E., Ahmad, S., Jain, M. K., Crecely, R. W., Apitz-Castro, R. J., & Cruz, M. R. (1984) · Journal of the American Chemical Society · doi:10.1021/ja00338a049 · Cited by 246 · see citing works
Adler, A., & Holub, B. J. (1997) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/65.2.445 · Cited by 229 · see citing works
Can garlic reduce levels of serum lipids? a controlled clinical study
Jain, A. K., Vargas, R., Gotzkowsky, S., & McMahon, F. G. (1993) · The American Journal of Medicine · doi:10.1016/0002-9343(93)90216-c · Cited by 229 · see citing works
Garlic Powder and Plasma Lipids and Lipoproteins
Isaacsohn, J. L., Moser, M., Stein, E. A., Dudley, K., Davey, J. A., Liskov, E., & Black, H. R. (1998) · Archives of Internal Medicine · doi:10.1001/archinte.158.11.1189 · Cited by 217 · see citing works
Effect of a Garlic Oil Preparation on Serum Lipoproteins and Cholesterol Metabolism
Berthold, H. K., Sudhop, T., & von Bergmann, K. (1998) · JAMA · doi:10.1001/jama.279.23.1900 · Cited by 208 · see citing works
Gebhardt, R., & Beck, H. (1996) · Lipids · doi:10.1007/bf02587912 · Cited by 205 · see citing works
Kendler, B. S. (1987) · Preventive Medicine · doi:10.1016/0091-7435(87)90050-8 · Cited by 169 · see citing works
Kleijnen, J., Knipschild, P. G., & ter Riet, G. (1989) · British Journal of Clinical Pharmacology · doi:10.1111/j.1365-2125.1989.tb03539.x · Cited by 168 · see citing works
The antiatherosclerotic effect of Allium sativum
Koscielny, J. (1999) · Atherosclerosis · doi:10.1016/s0021-9150(99)00060-x · Cited by 165 · see citing works
Effect of garlic on blood lipids in patients with coronary heart disease
Bordia, A. (1981) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/34.10.2100 · Cited by 163 · see citing works
On the effect of garlic on plasma lipids and lipoproteins in mild hypercholesterolaemia
Simons, L. A., Balasubramaniam, S., von Konigsmark, M., Parfitt, A., Simons, J., & Peters, W. L. (1995) · Atherosclerosis · doi:10.1016/0021-9150(94)05449-s · Cited by 141 · see citing works
Effect of essential oil of onion and garlic on experimental atherosclerosis in rabbits
Bordia, A., Verma, S. K., Vyas, A. K., Bl, K., Rathore, A. S., Bhu, N., & Bedi, H. K. (1977) · Atherosclerosis · doi:10.1016/0021-9150(77)90092-2 · Cited by 136 · see citing works
Garlic Powder in the Treatment of Moderate Hyperlipidaemia: A Controlled Trial and Meta-Analysis
Neil, H. A. W., Silagy, C. A., Lancaster, T., Hodgeman, J., Vos, K., Moore, J. W., Jones, L., Cahill, J., & Fowler, G. H. (1996) · Journal of the Royal College of Physicians of London · doi:10.1016/s0035-8819(25)00368-x · Cited by 133 · see citing works
How much of the placebo ‘effect’ is really statistical regression?
McDonald, C. J., & McCabe, G. P. (1989) · Statistics in Medicine · doi:10.1002/sim.4780081013 · Cited by 132 · see citing works
Garlic Extract Therapy in Children With Hypercholesterolemia
McCrindle, B. W., Helden, E., & Conner, W. T. (1998) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.152.11.1089 · Cited by 131 · see citing works
Harenberg, J., Giese, C., & Zimmermann, R. (1988) · Atherosclerosis · doi:10.1016/0021-9150(88)90244-4 · Cited by 128 · see citing works
Effect of an odor-modified garlic preparation on blood lipids
Lau, B. H. S., Lam, F. Z., & Wang-Cheng, R. M. (1987) · Nutrition Research · doi:10.1016/s0271-5317(87)80026-x · Cited by 113 · see citing works
Superko, H. R., & Krauss, R. M. (2000) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(99)90541-7 · Cited by 112 · see citing works
Steiner, M., & Lin, R. (1998) · Journal of Cardiovascular Pharmacology · doi:10.1097/00005344-199806000-00014 · Cited by 109 · see citing works
Effect of garlic on thrombocyte aggregation, microcirculation, and other risk factors.
Kiesewetter, H., Jung, F., Pindur, G., Jung, E. M., Mrowietz, C., & Wenzel, E. (1991) · PubMed · Cited by 106 · see citing works
Hypertension and hyperlipidaemia: garlic helps in mild cases.
Auer, W., Eiber, A., Hertkorn, E., Hoehfeld, E., Koehrle, U., Lorenz, A., Mader, F. M., Merx, W., Otto, G., & Schmid-Otto, B. (1990) · PubMed · Cited by 101 · see citing works
The effect of fried versus raw garlic on fibrinolytic activity in man
Chutani, S. K., & Bordia, A. (1981) · Atherosclerosis · doi:10.1016/0021-9150(81)90058-7 · Cited by 90 · see citing works
Therapy with garlic: results of a placebo-controlled, double-blind study.
Vorberg, G., & Schneider, B. (1990) · PubMed · Cited by 82 · see citing works
Effects of garlic coated tablets in peripheral arterial occlusive disease
Kiesewetter, H., Jung, F., Jung, F., Blume, J., Mrowietz, C., Birk, A., Koscielny, J., & Wenzel, E. (1993) · Journal of Molecular Medicine · doi:10.1007/bf00186628 · Cited by 82 · see citing works
Effect of garlic feeding on regression of experimental atherosclerosis in rabbits.
Bordia, A., & Verma, S. K. (1980) · PubMed · Cited by 77 · see citing works
Alteration of lipid profile in hyperlipidemic rabbits by allicin, an active constituent of garlic.
Eilat, S., Oestraicher, Y., Rabinkov, A., Ohad, D. G., Mirelman, D., Battler, A., Eldar, M., & Vered, Z. (1995) · PubMed · Cited by 77 · see citing works
Effect of garlic on serum lipids, coagulability and fibrinolytic activity of blood
Jain, R. (1977) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/30.9.1380 · Cited by 74 · see citing works
Kamanna, V. S., & Chandrasekhara, N. (1982) · Lipids · doi:10.1007/bf02535329 · Cited by 73 · see citing works
Cardiovascular effects of garlic (Allium sativum): a review.
Ernst, E. K. (1987) · PubMed · Cited by 65 · see citing works
The protective action of essential oils of onion and garlic in cholesterol-fed rabbits
Bordia, A., Arora, S., Kothari, L. K., et al. (1975) · Atherosclerosis · doi:10.1016/0021-9150(75)90071-4 · Cited by 64 · see citing works
Gadkari, J. V., & Joshi, V. (1991) · PubMed · Cited by 56 · see citing works
Hypocholesterolaemic effect of garlic, Allium sativum Linn.
Kt, A. (1977) · PubMed · Cited by 53 · see citing works
Comparison of the efficacy and tolerance of a garlic preparation vs. bezafibrate.
Holzgartner, H., Schmidt, U. H., & Kühn, U. (1992) · PubMed · Cited by 50 · see citing works
Lack of efficacy of dried garlic in patients with hyperlipoproteinemia.
Luley, C. H., Lehmann-Leo, W., Möller, B., Martín, T., & Schwartzkopff, W. (1986) · PubMed · Cited by 50 · see citing works
Hypolipidemic effects of garlic oil in rats fed ethanol and a high lipid diet
Shoetan, A., Augusti, K. T., & Joseph, P. K. (1984) · Cellular and Molecular Life Sciences · doi:10.1007/bf01947571 · Cited by 49 · see citing works
Does garlic alter the lipid pattern in normal volunteers?
Saradeth, T., Seidl, S., Resch, K. L., & Ernst, E. (1994) · Phytomedicine · doi:10.1016/s0944-7113(11)80062-0 · Cited by 38 · see citing works
Ernst, E., Weihmayr, T., & Mátrai, Á. (1985) · BMJ · doi:10.1136/bmj.291.6488.139-b · Cited by 37 · see citing works
Garlic and diabetes mellitus phase II clinical trial.
Sitprija, S., Plengvidhya, C., Kangkaya, V., Bhuvapanich, S., & Tunkayoon, M. (1987) · PubMed · Cited by 32 · see citing works
Bordia, A., Verma, S. K., Bl, K., et al. (1977) · PubMed · Cited by 29 · see citing works
Effect of garlic on normal blood cholesterol level.
Bhushan, S., Sharma, S. P., Singh, S., Agrawal, S., Indrayan, A., & Seth, P. (1979) · PubMed · Cited by 28 · see citing works
Modulation of lipid profile by fish oil and garlic combination.
Morcos, N. (1997) · PubMed Central · Cited by 28 · see citing works
Garlic Reduces Plasma Cholesterol in Hypercholesterolemic Men Maintaining Habitual Diets
Yeh, Y., Lin, R. I.-S., Yeh, S., & Evans, S. (1997) · Springer eBooks · doi:10.1007/978-4-431-67017-9_45 · Cited by 28 · see citing works
Brosche, T., Platt, D., & Dorner, H. B. (1990) · PubMed · Cited by 28 · see citing works
The Effect of Garlic on Hypercholesterolemia in Renal Transplant Patients
Lash, J. P., Cardoso, L. R., Mesler, P. M., Walczak, D., & Pollak, R. (1998) · Transplantation Proceedings · doi:10.1016/s0041-1345(97)01227-x · Cited by 25 · see citing works
Effect of Garlic on Serum Lipids
Lawson, L. D. (1998) · JAMA · doi:10.1001/jama.280.18.1568 · Cited by 25 · see citing works
Effects of spray dried garlic preparation on primary hyperlipoproteinemia.
Plengvidhya, C., Sitprija, S., Chinayon, S., Pasatrat, S., & Tankeyoon, M. (1988) · PubMed · Cited by 21 · see citing works
Rotzsch, W., Richter, V., Rassoul, F., & Walper, A. (1992) · PubMed · Cited by 14 · see citing works
Kenzelmann, R., & Kade, F. (1993) · PubMed · Cited by 8 · see citing works
… and German garlic study under scrutiny
Schiermeier, Q. (1999) · Nature · doi:10.1038/44225 · Cited by 5 · see citing works
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CORZOMARTINEZ, M., CORZO, N., & VILLAMIEL, M. (2007) · Trends in Food Science & Technology · doi:10.1016/j.tifs.2007.07.011 · Cited by 810 · see citing works
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Rahman, K., & Lowe, G. M. (2006) · The Journal of Nutrition · doi:10.1093/jn/136.3.736s · Cited by 447 · see citing works
Cicero, A. F. G., Colletti, A., Bajraktari, G., Descamps, O., Djuric, D. M., Ezhov, M., Fras, Z., Katsiki, N., Langlois, M., Latkovskis, G., et al. (2017) · Archives of Medical Science · doi:10.5114/aoms.2017.69326 · Cited by 281 · see citing works
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Banach, M., Patti, A. M., Giglio, R. V., Cicero, A. F. G., Atanasov, A. G., Bajraktari, G., Bruckert, E., Descamps, O., Djuric, D. M., Ezhov, M., et al. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.04.040 · Cited by 272 · see citing works
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Lawson, L. D., & Gardner, C. D. (2005) · Journal of Agricultural and Food Chemistry · doi:10.1021/jf050536+ · Cited by 227 · see citing works
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Borrelli, F., Capasso, R., & Izzo, A. A. (2007) · Molecular Nutrition & Food Research · doi:10.1002/mnfr.200700072 · Cited by 223 · see citing works
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Ansary, J., Forbes-Hernández, T. Y., Gil, E., Cianciosi, D., Zhang, J., Elexpuru-Zabaleta, M., Simal-Gandara, J., Giampieri, F., & Battino, M. (2020) · Antioxidants · doi:10.3390/antiox9070619 · Cited by 217 · see citing works
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Lawson, L. D., & Hunsaker, S. M. (2018) · Nutrients · doi:10.3390/nu10070812 · Cited by 207 · see citing works
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Gardner, C. D., Coulston, A., Chatterjee, L., Rigby, A., Spiller, G., & Farquhar, J. W. (2005) · Annals of Internal Medicine · doi:10.7326/0003-4819-142-9-200505030-00007 · Cited by 121 · see citing works
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- Authors
- Ackermann, R. T., Mulrow, C. D., Ramirez, G., Gardner, C. D., Morbidoni, L., & Lawrence, V. A.
- Affiliations
- Audie L. Murphy Memorial VA Hospital (US)
- The University of Texas at San Antonio Health Science Center (US)
- University of California, Davis (US)
- Marche Polytechnic University (IT)
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2001-03-26
- Volume
- 161
- Issue
- 6
- Pages
- 813
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W1964476694
- Cited by
- 295
- References
- 62
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 6 · 2022: 7 · 2021: 5 · 2020: 11 · 2019: 11 · 2018: 10 · 2017: 8 · 2016: 15 · 2015: 14 · 2014: 8 · 2013: 11 · 2012: 19
- FWCI
- 20.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Agricultural and Biological Sciences › Plant Science › Garlic and Onion Studies
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Surgery › Natural Products and Biological Research
- Keywords
- garlic, cardiovascular risk factors, cholesterol, serum lipids, low-density lipoprotein, triglycerides, high-density lipoprotein, platelet aggregation, blood pressure, glycemic control, adverse effects, flatulence, hemorrhage, antiplatelet activity
- MeSH terms
- Adolescent, Adult, Aged, Antihypertensive Agents, Hypolipidemic Agents, Cardiovascular Diseases, Female, Fibrinolytic Agents, Garlic, Humans, Hypoglycemic Agents, Male, Phytotherapy, Middle Aged, Plants, Medicinal, Risk Factors, Randomized Controlled Trials as Topic, Treatment Outcome
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