Cardiovascular disease.
Gore JM; Dalen JE
University of Massachusetts Medical School,
Worcester.
JAMA (United States) Jun 1 1994, 271 (21)
p1660-1
The GUSTO angiographic trial helps to confirm
the open artery theory. Cholesterol levels in US
adults continue to decrease. The consumption of
one-half to one clove of garlic per day reduces
cholesterol levels by approximately 9%.
Garlic as
a lipid lowering agent--a
meta-analysis.
Silagy C; Neil A
Department of Public Health and Primary Care,
University of Oxford.
J R Coll Physicians Lond (England) Jan-Feb 1994,
28 (1) p39-45
Garlic supplements may have an important role
to play in the treatment of hypercholesterolaemia.
To determine the effect of garlic on serum lipids
and lipoproteins relative to placebo and other
lipid lowering agents, a systematic review,
including meta-analysis, was undertaken of
published and unpublished randomised controlled
trials of garlic preparations of at least four
weeks' duration. Studies were identified by a
search of MEDLINE and the ALTERNATIVE MEDICINE
electronic databases, from references listed in
primary and review articles, and through direct
contact with garlic manufacturers. Sixteen trials,
with data from 952 subjects, were included in the
analyses. Many of the trials had methodological
shortcomings. The pooled mean difference in the
absolute change (from baseline to final
measurement in mmol/l) of total serum cholesterol,
triglycerides, and high-density lipoprotein (HDL)-
cholesterol was compared between subjects treated
with garlic therapy against those treated with
placebo or other agents. The mean difference in
reduction of total cholesterol between garlic
-treated subjects and those receiving placebo (or
avoiding garlic in their diet) was -0.77 mmol/l
(95% CI: -0.65, -0.89 mmol/l). These changes
represent a 12% reduction with garlic therapy
beyond the final levels achieved with placebo
alone. The reduction was evident after one month
of therapy and persisted for at least six months.
In the dried garlic powders, in which the allicin
content is standardised, there was no significant
difference in the size of the reduction across the
dose range of 600-900 mg daily. Dried garlic
powder preparations also significantly lowered
serum triglyceride by 0.31 mmol/l compared to
placebo (95% CI: -0.14, -0.49).(ABSTRACT TRUNCATED
AT 250 WORDS)
Limitation of the deterioration of
lipid parameters by a standardized garlic -ginkgo
combination product. A multicenter
placebo-controlled double-blind
study.
Kenzelmann R; Kade F
Institute for Clinical Research, Gumlingen
Switzerland.
Arzneimittelforschung (Germany) Sep 1993, 43 (9)
p978-81
The efficacy of a garlic -ginkgo combination
product (Allium plus) was analyzed in a randomized
placebo-controlled double-blind study under
extreme dietary conditions. The Christmas/New
Year's season was chosen for this 2 months lasting
investigation analyzing whether the known
cholesterol lowering effect of garlic was even
effective during the period of the year with the
most cholesterol -rich meals. 43 patients with
elevated total cholesterol levels ranging between
230-390 mg/dl completed the study. There were no
significant changes of the total cholesterol
values in both treatment groups. Nevertheless the
analysis of improvement or deterioration of total
cholesterol values revealed a clear difference
between verum and placebo. 20% of the patients in
the placebo group showed an improvement of their
total cholesterol level, while there was a
significant greater improvement rate of 35% in the
verum group (p < 0.05). The responders of the
verum group showed a reduction in the total
cholesterol values from 298.5 +/- 53.8 to 293.0
+/- 56.4 mg/dl after 1 month and a total reduction
of 10.4% after 2 months to 267.6 +/- 44.4 mg/dl.
The difference after 2 months of treatment was
significantly different from the starting value (p
< 0.05). After the 2 months treatment phase
there was a 2 weeks wash-out period. During this
period the total cholesterol value returned to
293.5 +/- 90.1 mg/dl showing the effectiveness of
garlic treatment, but indicating the need for a
continuous long-term therapy.
Inter-relationships between
haemostatic tests and the effects of some dietary
determinants in the Caerphilly cohort of older
men.
Elwood PC; Beswick AD; O'Brien JR; Yarnell JW;
Layzell JC; Limb ES
MRC Epidemiology Unit, Llandough Hospital,
Penarth, South Glamorgan.
Blood Coagul Fibrinolysis (England) Aug 1993, 4
(4) p529-36
Inter-relationships between fibrinogen,
platelets and other haemostatic factors were
examined in 1030 men aged 55-99 years. Fasting
blood was taken and used for cell counts, platelet
counts and platelet parameters, aggregation of
platelets to ADP by a whole blood method and a
filter test of platelet activation. Plasma
fibrinogen, von Willebrand factor, factor VII and
plasma viscosity were measured by standard
methods. A stressed bleeding time was conducted on
the forearm of the arm not used for venepuncture.
Variability within the laboratory and short-term
intra-subject variation were examined and found to
be acceptably small. The effect of age on the
tests was modest, except for von Willebrand factor
which increased by about 50% of a SD for every 10
years of age. Cholesterol and triglyceride levels
had small effects on the platelet tests and a
large effect on factor VII. A number of dietary
and life-style determinants were examined: smokers
had increased levels of fibrinogen, viscosity and
white cell count and reduced bleeding times.
Alcohol drinkers showed reduced platelet activity
and have lower levels of fibrinogen, von
Willebrand factor and white cell count. Men who
took fish oil capsules had substantially increased
bleeding times and lower levels of von Willebrand
factor and men who took capsules containing an
extract of garlic showed reduced platelet
retention in the filter test.
Effect of
garlic on total serum cholesterol. A
meta-analysis
Warshafsky S; Kamer RS; Sivak SL
Department of Medicine, New York Medical College,
Valhalla 10595.
Ann Intern Med (United States) Oct 1 1993, 119 (7
Pt 1) p599-605
OBJECTIVE: To assess the size and consistency
of garlic 's effect on total serum cholesterol in
persons with cholesterol levels greater than 5.17
mmol/L (200 mg/dL).
DATA SOURCES: Clinical trials were identified
by a computerized literature search of MEDLINE and
by an assessment of the bibliographies of
published studies and reviews.
STUDY SELECTION: Trials were selected if they
were randomized and placebo-controlled and if at
least 75% of their patients had cholesterol levels
greater than 5.17 mmol/L (200 mg/dL). Studies were
excluded if they did not provide enough data to
compute effect size. Five of 28 studies were
selected for review.
DATA EXTRACTION: Details of study design,
patient characteristics, interventions, duration
of therapy, and cholesterol measurements were
extracted by one author and were verified by
another.
DATA SYNTHESIS: Study quality was evaluated by
multiple reviewers using a closed-ended
questionnaire. Patients treated with garlic
consistently showed a greater decrease in total
cholesterol levels compared with those receiving
placebo. Meta-analysis of homogeneous trials
estimated a net cholesterol decrease attributable
to garlic of 0.59 mmol/L (95% CI, 0.44 to 0.74)
(23 mg/dL [CI, 17 to 29]) (P < 0.001).
CONCLUSIONS: Meta-analysis of the controlled
trials of garlic to reduce hypercholesterolemia
showed a significant reduction in total
cholesterol levels. The best available evidence
suggests that garlic, in an amount approximating
one half to one clove per day, decreased total
serum cholesterol levels by about 9% in the groups
of patients studied.
Effects
of garlic coated tablets in peripheral arterial
occlusive disease.
Kiesewetter H; Jung F; Jung EM; Blume J;
Mrowietz C; Birk A; Koscielny J; Wenzel E
Abteilung fur Klinische Hamostaseologie und
Transfusionsmedizin, Universitat des Saarlandes,
Homburg/Saar.
Clin Investig (Germany) May 1993, 71 (5)
p383-6
For the first time, a weak clinical efficacy of
a 12-week therapy with garlic powder (daily dose,
800 mg) is demonstrated in patients with
peripheral arterial occlusive disease stage II.
The increase in walking distance in the verum
group by 46 m (from 161.0 +/- 65.1 to 207.1 +/-
85.0 m) was significantly higher (P < 0.05)
than in the placebo group (by 31 m, from 172.0 +/-
60.9 to 203.1 +/- 72.8). Both groups received
physical therapy twice a week. The diastolic blood
pressure, spontaneous thrombocyte aggregation,
plasma viscosity, and cholesterol concentration
also decreased significantly. Body weight was
maintained. It is quite interesting that the
garlic -specific increase in walking distance did
not appear to occur until the 5th week of
treatment, connected with a simultaneous decrease
in spontaneous thrombocyte aggregation. Therefore,
garlic may be an appropriate agent especially for
the long-term treatment of an incipient
intermittent claudication.
Can
garlic reduce levels of serum lipids? A controlled
clinical study.
Jain AK; Vargas R; Gotzkowsky S; McMahon FG
Clinical Research Center, New Orleans, Louisiana
70112.
Am J Med (United States) Jun 1993, 94 (6)
p632-5
PURPOSE: To assess the effects of standardized
garlic powder tablets on serum lipids and
lipoproteins, glucose, and blood pressure.
SUBJECTS AND METHODS: Forty-two healthy adults
(19 men, 23 women), mean age of 52 +/- 12 years,
with a serum total cholesterol (TC) level of
greater than or equal to 220 mg/dL received, in a
randomized, double-blind fashion, either 300 mg
three times a day of standardized garlic powder in
tablet form or placebo. Diets and physical
activity were unchanged. This study was conducted
in an outpatient, clinical research unit.
RESULTS: The baseline serum TC level of 262 +/-
34 mg/dL was reduced to 247 +/- 40 mg/dL (p <
0.01) after 12 weeks of standard garlic treatment.
Corresponding values for placebo were 276 +/- 34
mg/dL before and 274 +/- 29 mg/dL after placebo
treatment. Low-density lipoprotein cholesterol
(LDL-C) was reduced by 11% by garlic treatment and
3% by placebo (p < 0.05). There were no
significant changes in high-density lipoprotein
cholesterol, triglycerides, serum glucose, blood
pressure, and other monitored parameters.
CONCLUSIONS: Treatment with standardized garlic
900 mg/d produced a significantly greater
reduction in serum TC and LDL-C than placebo. The
garlic formulation was well tolerated without any
odor problems.
Hypertension and hyperlipidaemia:
garlic helps in mild cases.
Auer W; Eiber A; Hertkorn E; Hoehfeld E;
Koehrle U; Lorenz A; Mader F; Merx W; Otto G;
Schmid-Otto B; et al
Incorporated Society, Nittendorf, West
Germany.
Br J Clin Pract Suppl (England) Aug 1990, 69
p3-6
Forty-seven non-hospitalised patients with mild
hypertension took part in a randomised,
placebo-controlled, double-blind trial conducted
by 11 general practitioners. The patients who were
admitted had diastolic blood pressures between 95
and 104 mmHg after a two-week acclimatization
phase. The patients then took either a preparation
of garlic powder (Kwai) or a placebo of identical
appearance for 12 weeks. Blood pressure and plasma
lipids were monitored during treatment after four,
eight and 12 weeks. Significant differences
between the placebo and the drug group were found
during the course of therapy. For example, the
supine diastolic blood pressure in the group
having garlic treatment fell from 102 to 91 mmHg
after eight weeks (p less than 0.05) and to 89
mmHg after 12 weeks (p less than 0.01). The serum
cholesterol and triglycerides were also
significantly reduced after eight and 12 weeks of
treatment. In the placebo group, on the other
hand, no significant changes occurred.
Therapy
with garlic: results of a placebo-controlled,
double-blind study.
Vorberg G; Schneider B
University of Hannover, West Germany.
Br J Clin Pract Suppl (England) Aug 1990, 69
p7-11
A double-blind study of 40
hypercholesterolaemic out-patients was carried out
over a period of four months to examine the
effects of a garlic powder preparation*. The drug
group received 900 mg garlic powder per day,
equivalent to 2,700 mg of fresh garlic . During
the therapy, the drug group showed significantly
lower total cholesterol, triglycerides and blood
pressure than those of the placebo group. In
addition, results of a self-evaluation
questionnaire indicated that patients in the drug
group had a greater feeling of 'well-being'.
The
effect of a garlic preparation on the composition
of plasma lipoproteins and erythrocyte membranes
in geriatric subjects.
Brosche T; Platt D; Dorner H
Chair of Internal Medicine-Gerontology,
University of Erlangen-Nuremberg, West Germany.
Br J Clin Pract Suppl (England) Aug 1990, 69
p12-9
This study evaluated the effect of a dried
garlic powder preparation, standardised to 1.3%
alliin, on the composition of plasma lipoproteins
and erythrocyte membranes. Forty volunteers, aged
70 years and over, took 600 mg of garlic powder
per day for three months. In participants with
initially normal plasma cholesterol levels (CH
less than 200 mg/dl; n = 11) after three months of
garlic tablet administration, little or no change
in CH values was registered, as for most of the
other parameters. In contrast, in volunteers with
initially elevated CH levels (CH greater than 200
mg/dl, n = 29), the CH levels were reduced by
-7.7% (p less than 0.001). This reduction took
place primarily in the esterified cholesterol
fraction (-12%, p less than 0.001), whereas free
cholesterol concentrations were not altered
significantly. Triglycerides (-15.9%, p less than
0.05) and plasma choline phospholipids (-4.6%, p
less than 0.01) were also reduced. No change of
the plasma LDL-CH to HDL-CH ratio was observed in
this group. Based on the weight of lyophilised,
haemoglobin-free erythrocytes, the mean membrane
concentration of phospholipids and cholesterol in
the total cohort (n = 40) increased by 5.7% (p
less than 0.001) and 6.1% (p less than 0.01),
respectively. These increases were more pronounced
the lower the body mass indices (kg/m2) were, and
the longer the duration of garlic administration
was. The molar ratio of membrane phospholipids to
cholesterol remained unchanged. The results are
discussed with regard to a possible role of the
garlic -induced membrane effects in the plasma
lipid-lowering potency of garlic and preparations
made from it.
Comparison of the efficacy and
tolerance of a garlic preparation vs.
bezafibrate.
Holzgartner H; Schmidt U; Kuhn U
Arbeits- und Forschungsgemeinschaft fur
Arzneimittel-Sicherheit e.V., Cologne, Fed. Rep.
of Germany.
Arzneimittelforschung (Germany) Dec 1992, 42 (12)
p1473-7
The efficacy and tolerance of a garlic
preparation (Sapec, Kwai) was investigated in a
randomized double-blind study vs. bezafibrate.
This multi-centre study was conducted in 5 general
medical practices and involved 98 patients with
primary hyperlipoproteinaemia. The daily doses of
the active substances were 900 mg of garlic powder
(standardized as to 1.3% alliin) and 600 mg of
bezafibrate, respectively. The pre-phase with
placebo lasted 6 weeks, the treatment period
covered 12 weeks. All patients were advised to
observe a low-fat "step-1 diet" for the duration
of the study. The 98 case report forms allowed the
statistical evaluation of total cholesterol, HDL
cholesterol and triglyceride levels for 94
patients, and of LDL cholesterol values for 92
patients. In the course of the treatment both
study medications caused a statistically highly
significant reduction in total cholesterol, in LDL
cholesterol and triglycerides, and an increase in
HDL cholesterol . However, there was no
significant difference in the efficacies of both
medication groups. Side effects were mentioned by
5 patients each in both treatment groups, none of
which led to the withdrawal of the patients.
Concerning the garlic preparation, there was no
correlation between the perception of garlic odour
and the influence on the cholesterol level.
[Postprandial lipemia under treatment
with Allium sativum. Controlled double-blind study
of subjects with reduced HDL2- cholesterol]
Rotzsch W; Richter V; Rassoul F; Walper A
Institut fur Klinische Chemie und
Laboratoriumsdiagnostik, Universitat Leipzig.
Arzneimittelforschung (Germany) Oct 1992, 42 (10)
p1223-7
Postprandial Lipaemia under Treatment with
Allium sativum/Controlled double-blind study in
healthy volunteers with reduced HDL2-cholesterol
levels. The effectiveness of a standardized garlic
powder preparation (Sapec, Kwai) on alimentary
hypertriglyceridaemia after intake of a
standardized fatty test meal containing 100 g
butter was analyzed in a randomized
placebo-controlled double-blind study. 24
volunteers with HDL2- cholesterol concentrations
in plasma of less than 10 mg/dl (men) respectively
15 mg/dl (women) participated in the study. The
volunteers received 3 times 1 tablet daily over a
period of 6 weeks equivalent to a daily dosage of
900 mg garlic powder in the active treated group.
Control measurements were made on the 1st, 22nd
and 43rd day of treatment and 0, 3 and 5 h after
intake of the meal. The postprandial increase of
triglycerides was clearly reduced under garlic
medication as compared to placebo treatment. The
determined AUC-values for the triglycerides were
up to 35% lower in the garlic group compared to
the placebo group. The regular intake of the
garlic preparation over the period of 6 weeks
showed a significant lowering of the fasting
values of triglycerides in comparison to placebo.
Under garlic medication HDL2- cholesterol
increased more than under placebo in tendency.
Effect
of ingestion of raw garlic on serum cholesterol
level, clotting time and fibrinolytic activity in
normal subjects.
Gadkari JV; Joshi VD
Department of Physiology, L. T. M. Medical
College, Sion, Bombay, Maharashtra.
J Postgrad Med (India) Jul 1991, 37 (3)
p128-31
The effect of raw garlic on serum cholesterol,
fibrinolytic activity and clotting time was
studied in 50 medical students of the age group of
17 to 22 years before and after feeding raw garlic
. All pre-experimental values ranged within normal
limits. The volunteers were then divided into
experimental and control groups. The subjects of
the experimental group were given 10 gm of raw
garlic daily after breakfast for two months.
Fasting blood samples of all the subjects were
investigated after two months. In the control
group, there was no significant change in any of
the above parameters. In the experimental group,
there was a significant decrease in serum
cholesterol and an increase in clotting time and
fibrinolytic activity. Hence, garlic may be an
useful agent in prevention of thromboembolic
phenomenon.
Effect
of garlic on thrombocyte aggregation,
microcirculation, and other risk
factors.
Kiesewetter H; Jung F; Pindur G; Jung EM;
Mrowietz C; Wenzel E
Department of Clinical Hemostasiology and
Transfusion Medicine, University of the Saarland,
Homburg.
Int J Clin Pharmacol Ther Toxicol (Germany) Apr
1991, 29 (4) p151-5
Significant positive effects could be achieved
in a placebo-controlled double-blind study through
the administration of 800 mg of garlic powder over
a period of four weeks. Spontaneous thrombocyte
aggregation disappeared, the microcirculation of
the skin increased by 47.6% (from 0.63 +/- 0.13 to
0.93 +/- 0.22 mm/s), plasma viscosity decreased by
3.2% (from 1.25 +/- 0.34 to 1.21 +/- 0.43 mPas),
diastolic blood pressure by 9.5% (from 74 +/- 9 to
67 +/- 5 mmHg), and blood glucose concentration by
11.6% (from 89.4 +/- 8.8 to 79.0 +/- 11.9 mg/dl).
The vascular protection of garlic as
atherosclerosis prevention by influencing the
mentioned risk parameters for cardiovascular
diseases must be pointed out. Especially
interesting is the thrombocyte aggregation
inhibiting effect. Thus, the application of garlic
may be useful in case of acetylsalicyclic acid
intolerance.
[Garlic
as phytogenic antilipemic agent. Recent studies
with a standardized dry garlic powder substance]
Brosche T; Platt D
Lehrstuhl fur Innere Medizin-Gerontologie,
Universitat Erlangen-Nurnberg.
Fortschr Med (Germany) Dec 20 1990, 108 (36)
p703-6
Garlic (Allium sativum L.) is a commonplace
drug. It is now available in the form of dragees
made of garlic powder, standardized to 1.3%
alliin. The lipid-lowering potential of such
preparations has not been reviewed yet. In 7 out
of 8 studies, including over 500 patients, a daily
dose of 0.6 g to 0.9 g garlic powder reduced
plasma cholesterol and triglyceride levels by 5 to
20 percent. The metabolic mechanisms of these
reductions are not known. (0 Refs.)
Treatment of hyperlipidaemia with
garlic-powder tablets. Evidence from the German
Association of General Practitioners' multicentric
placebo-controlled double-blind
study.
Mader FH
Study Group on Phytotherapy of the German
Association of General Practitioners,
Nittendorf.
Arzneimittelforschung (Germany) Oct 1990, 40 (10)
p1111-6
In a multicentric placebo-controlled randomised
study the effect of standardized garlic -powder
tablets (Kwai, Sapec) in the treatment of
hyperlipidaemia was investigated. A total of 261
patients of 30 general practitioners in West
Germany with total cholesterol and/or triglyceride
values more than 200 mg/dl (mostly
hyperlipoproteinaemia type II a/II b) took part in
the study. Patients were randomly allocated to
take tablets containing a total of 800 mg garlic
powder (standardized to 1.3% of alliin content)
daily or the same number of placebo tablets for 16
weeks (monthly controlled). 221 patients were used
for statistical analysis of total cholesterol and
219 patients for the analysis of triglyceride
values. Mean serum cholesterol levels dropped in
the verum group from 266 to 235 mg/dl (i.e. 12%)
during the 4 month treatment period, mean
triglyceride values fell in the verum group from
226 to 188 mg/dl (i.e. 17%). The best cholesterol
lowering effects were seen in the patients with
initial total cholesterol values between 250-300
mg/dl. The difference between the verum and
placebo group was highly significant (p less than
0.001). A mild garlic smell was observed in up to
21% of the verum group and up to 9% in the placebo
group. Only one of the patients left the study for
this reason. Standardized garlic tablets have been
shown to be effective in the treatment of
hyperlipidaemia by lowering total cholesterol
values by an average of 12% and triglyceride
values by an average of 17%.
Garlic,
onions and cardiovascular risk factors. A review
of the evidence from human experiments with
emphasis on commercially available
preparations
Kleijnen J; Knipschild P; ter Riet G
Department of Epidemiology/Health Care Research,
University of Limburg, Maastricht, The
Netherlands.
Br J Clin Pharmacol (England) Nov 1989, 28 (5)
p535-44
1. Claims for beneficial effects on cholesterol
levels, fibrinolytic activity, and platelet
aggregation are attributed both to fresh garlic
and onions (or their extracts) and to commercially
available preparations.
2. Regarding fresh garlic, the claims have been
confirmed, but so far only at very high
dosages.
3. For onions and commercially available
supplements contradictory results have been
reported.
4. All published trials showed severe
methodological shortcomings. Some trials were not
randomized and/or not blinded whilst this was
possible, and in only one of every three studies
more than 25 patients participated in each
treatment group. In no trial was prognostic
comparability of the treatment and the control
groups ascertained. At the moment there is
inadequate scientific justification for garlic
supplementation. (39 Refs.)
Effect
of dried garlic on blood coagulation,
fibrinolysis, platelet aggregation and serum
cholesterol levels in patients with
hyperlipoproteinemia.
Harenberg J; Giese C; Zimmermann R
First Medical Department, Klinikum Mannheim,
University of Heidelberg, F.R.G.
Atherosclerosis (Netherlands) Dec 1988, 74 (3)
p247-9
The effects of intake of dried garlic on blood
coagulation, fibrinolysis, platelet aggregation,
serum cholesterol levels, and blood pressure were
studied in 20 patients with hyperlipoproteinemia
over a period of four weeks. Fibrinogen and
fibrinopeptide A significantly decreased by 10%.
Streptokinase activated plasminogen and
fibrinopeptide B beta 15-42 significantly
increased by about 10%. Serum cholesterol levels
significantly decreased by 10%. Systolic and
diastolic blood pressure decreased. ADP and
collagen induced platelet aggregation were not
influenced.
Lack of
efficacy of dried garlic in patients with
hyperlipoproteinemia.
Luley C; Lehmann-Leo W; Moller B; Martin T;
Schwartzkopff W
Arzneimittelforschung (Germany, West) Apr 1986,
36 (4) p766-8
The effects of dried garlic on blood lipids,
apolipoproteins and blood coagulation parameters
in hyperlipemic patients were studies in two
controlled, randomized, double-blind studies. Both
studies comprised placebo and therapy periods of 6
weeks each. The doses administered were 3 X 198 mg
in Study I (34 patients) and 3 X 450 mg in Study
II (51 patients). In both studies, the following
serum parameters were measured every 3 weeks:
total cholesterol, HDL (high density lipoprotein)-
and LDL (low density lipoprotein)- cholesterol,
triglycerides and several safety parameters. In
addition, apolipoproteins A and B, euglobulin
lysis time, fibrin split products, prothrombin
time, whole blood coagulation time and fibrinogen
levels were determined in the second study only.
The results indicated that neither dosage of dried
garlic showed any significant effect on any of the
parameters measured. It is therefore concluded
that, if there is any effect of garlic on the
parameters measured, it is not apparent when using
a dried preparation in the dosage studied.
Bulgarian traditional medicine: a
source of ideas for phytopharmacological
investigations.
Petkov V
J Ethnopharmacol (Switzerland) Feb 1986, 15 (2)
p121-32
Some data about the use of medicinal plants in
Bulgarian traditional medicine in the Middle Ages
and in modern times are presented and the results
of 40-year-long experimental-pharmacological
investigations on many medicinal plants used in
Bulgarian traditional medicine are reviewed.
In-depth discussion is presented on the
investigations of garlic (Allium sativum L.), a
plant widely used by Bulgarian people for treating
different diseases. Data from studies on a large
number of plants used for treatment of
hypertension, infectious diseases and as diuretic
and spasmolytic remedies are summarized. (51
Refs.)
Influence of garlic on serum
cholesterol, serum triglycerides, serum total
lipids and serum glucose in human
subjects.
Bakhsh R; Chughtai MI
Nahrung (Germany, East) 1984, 28 (2) p159-63
Human subjects were used for a garlic
experiment. The subjects were given a fat-rich
diet for 7 days and on the 8th day the fasting
blood was analyzed for serum cholesterol, serum
triglycerides, serum total lipids and serum
glucose. The human subjects were then given a
fat-rich diet with 40 g of garlic for 7 days and
on the 15th day the fasting blood was analyzed for
the above investigations. On a fat-rich diet the
serum cholesterol, serum triglycerides and serum
total lipids were significantly increased as
compared to normally fed diet. When 40 g of garlic
was substituted in fat-rich diet for 7 days, the
garlic significantly reduced the serum cholesterol
and serum triglycerides.
[Garlic
therapy? Theories of a folk remedy (author's
transl)]
Ernst E
MMW Munch Med Wochenschr (Germany, West) Oct 9
1981, 123 (41) p1537-8
Garlic has had a firm place in folk medicine
since ancient times. More recent results are
summarized here which show that extracts of the
plant have an antimicrobial action, they are
capable of lowering blood cholesterol and of
reducing secondary vascular changes. They raise
fibrinolytic activity and inhibit thrombocyte
aggregation. Therefore the plant contains highly
active therapeutic principles which appear to be
particularly suitable for prophylaxis of
arteriosclerosis.
The
structure-hemolysis relationship of oleanolic acid
derivatives and inhibition of the saponin-induced
hemolysis with sapogenins.
Hase J; Kobashi K; Mitsui K; Namba T; Yoshizaki
M; Tomimori T
J Pharmacobiodyn (Japan) Nov 1981, 4 (11)
p833-7
Chikusetsusaponin IV and V, whose genin is
oleanolic acid, exhibited weak hemolytic
activities. Removal of glucose residue at position
29 of chikusetsusaponin V by partial hydrolysis
increased the activity more than 30-fold.
Methylation of the carboxyl group at position 28
increased the activity furthermore by about
10-fold, showing HD50 value of 3.77 microM. On the
other hand, removal of the sugar chain at position
3 of chickusetsusaponin V by partial hydrolysis
completely lost the activity. These facts suggest
that the sugar chain at position 3 of oleanolic
acid is essential but that at position 29 is
pernicious for the activity. The cytolytic agents,
whose target has been regarded as membrane
cholesterol, were inactivated not only by
cholesterol but also by sapogenins such as
oleanolic acid, gitogenin and hederagenin. Among
saponins tested, akebia saponin B and C were
inactivated by cholesterol, but not by the genins,
probably because their affinities for the genins
are too low to form complexes.
The
long-term use of garlic in ischemic heart
disease--an appraisal.
Arora RC; Arora S; Gupta RK
Atherosclerosis (Netherlands) Oct 1981, 40 (2)
p175-9
The hypocholesterolemic and
fibrinolysis-enhancing properties of garlic were
assessed in patients with ischemic heart disease
(IHD) and in healthy control subjects. The peak of
blood fibrinolytic activity (BFA) achieved at the
4th week of garlic therapy was not sustained
despite its continuous use and returned to about
the pre-garlic values at the 12th week. Garlic
withdrawal did not cause any further change in
BFA. Under the same conditions serum total
cholesterol (STC) values did not show any
significant change. Both of the foregoing features
were observed in the IHD as well as in the control
group. Garlic therapy for 12 weeks did not cause
any appreciable changes in serum triglyceride,
beta-lipoprotein, plasma fibrinogen levels or
coagulation time in either IHD or control
subjects. The evidence cited above does not appear
to substantiate the prevalent popular belief in
the efficacy of garlic in the management of IHD
either as a hypocholesterolemic or as a
fibrinolytic agent.
Comparative effect of clofibrate,
garlic and onion on alimentary
hyperlipemia.
Arora RC; Arora S
Atherosclerosis (Netherlands) Jul 1981, 39 (4)
p447-52
The effect of clofibrate on the same subjects
in similar test conditions were used as a control
to verify the alleged beneficial effects from
garlic and onion on alimentary hyperlipemia in
normals and in cases with ischemic heart disease.
The results showed that clofibrate checked the
fat-induced (a) rises of serum triglyceride and
plasma fibrinogen, and (b) falls of coagulation
time (CT) and blood fibrinolytic activity (BFA).
Only garlic had a clofibrate-like effect on CT but
both garlic and onion checked the postprandial
fall of BFA. Clofibrate, however, increased BFA
even above the fasting level. Serum cholesterol
and beta-lipoprotein were not appreciably affected
by fat with or without any drug. Thus,
surprisingly, the so-called beneficial effects of
garlic and onion were not seen in subjects who had
shown significant changes after clofibrate.
Effect
of garlic on normal blood cholesterol
level.
Bhushan S; Sharma SP; Singh SP; Agrawal S;
Indrayan A; Seth P
Indian J Physiol Pharmacol (India) Jul-Sep 1979,
23 (3) p211-4
The effect of raw garlic on normal blood
cholesterol level in males of the age group of
18-35 years was studied. The subjects, who never
ingested garlic before, were given 10 g of garlic
daily with their diet for two months. Fasting
blood samples were investigated in respect of
cholesterol before and after two months of garlic
intake. Initially the blood cholesterol level
ranged between 160-250 mg% which decreased
significantly in all the subjects of experimental
group after two months of ingestion of garlic .
The slight decrease or increase in the blood
cholesterol level of control group was not
significant. The raw garlic can be advocated for
daily ingestion in order to lower one's blood
cholesterol level even if it is within normal
limits.
Effect
of the essential oils of garlic and onion on
alimentary hyperlipemia.
Bordia A; Bansal HC; Arora SK; Singh SV
Atherosclerosis (Netherlands) Jan-Feb 1975, 21
(1) p15-9
Summary: The effect of garlic and onion on
alimentary hyperlipemia, induced by feeding 100 g
butter, has been studied in 10 healthy subjects.
The freshly extracted juice of 50 g of garlic or
onion, as well as an equivalent amount of their
ether-extracted essential oils, was administered
randomly on four different days during a one-week
period. Garlic and onion have a significant
protective action against fat-induced increases in
serum cholesterol and plasma fibrinogen and
decreases in coagulation time and fibrinolytic
activity. The essential oil fraction, which
contains all the taste and odour, exactly
duplicated the beneficial effects of whole garlic
and onion. It is, therefore, concluded that the
active principle of garlic and onion is the
essential oil, which chemically is a combination
of sulphur-containing compounds, mainly allyl
propyl disulphide and diallyl disulphide.
Garlic
extract therapy in children with
hypercholesterolemia
McCrindle B.W.; Helden E.; Conner W.T.
Dr. B.W. McCrindle, Hospital for Sick Children,
555 University Ave, Toronto, Ont. M5G 1X8
Canada
Archives of Pediatrics and Adolescent Medicine
(United States), 1998, 152/11 (1089-1094)
Objective: To determine whether garlic extract
therapy is efficacious and safe in children with
hypercholesterolemia.
Design: Randomized, double- blind,
placebo-controlled clinical trial.
Setting: Specialized pediatric lipid disorders
ambulatory clinic.
Participants: Thirty pediatric patients, aged 8
to 18 years, who had familial hyperlipidemia and a
minimum fasting total cholesterol level greater
than 4.8 mmol/L (>185 mg/dL).
Intervention: An 8-week course of a
commercially available garlic extract (Kwai
[Lichtwer Phanna, Berlin, Germany], 300 mg, 3
times a day) or an identical placebo.
Main Outcome Measures: Absolute and relative
changes in fasting lipid profile parameters.
Results: The groups were equivalent at baseline
and compliance was similar in the 2 groups (P =
.45). There was no significant relative
attributable effect of garlic extract on fasting
total cholesterol (+0.6% [95% confidence interval,
-5.8% to +6.9%]) or low-density lipoprotein
cholesterol (-0.5% [95% confidence interval, -8.7%
to +7.6%]). The lower limits of the confidence
intervals did not include -10%, the minimum
relative attributable effect believed to be
clinically important. Likewise, no significant
effect was seen on the levels of high-density
lipoprotein, triglycerides, apolipoprotein B-100,
lipoprotein (a), fibrinogen, homocysteine, or
blood pressure. There was a small effect on
apolipoprotein A-I (+10.0% [95% confidence
interval, + 1.2% to + 16.5%] P=.03). There were no
differences in adverse effects between groups.
Conclusion: Garlic extract therapy has no
significant effect on cardiovascular risk factors
in pediatric patients with familial
hyperlipidemia.
Herbal
'health' products: What family physicians need to
know
Zink T.; Chaffin J.
Dr. T. Zink, Univ. of Cincinnati Coll. of Med.,
Cincinnati, OH United States
American Family Physician (United States), 1998,
58/5 (1133-1140)
Patients who self-medicare with herbs for
preventive and therapeutic purposes may assume
that these products are safe because they are
'natural,' but some products cause adverse effects
or have the potential to interact with
prescription medications. The United States lacks
a regulatory system for herbal products. Although
only limited research on herbs has been published,
St John's wort shows promise as a treatment for
depression. Ginkgo biloba extract is possibly
effective for cerebrovascular insufficiency and
dementia. Feverfew is used extensively in Canada
for migraine prophylaxis but needs more rigorous
study. Ephedrine has been regulated by many states
because its misuse has been associated with
several deaths. Echinacea is being tried as an
agent for immune stimulation, and garlic is under
study for cholesterol -lowering properties, but
both require more study. Physicians should educate
themselves and their patients about the efficacy
and adverse interactions of herbal agents and the
limitations of our present knowledge of them.
Changes
in platelet function and susceptibility of
lipoproteins to oxidation associated with
administration of aged garlic extract
Steiner M.; Lin R.S.
Dr. M. Steiner, Division of Hematology/Oncology,
East Carolina University, School of Medicine,
Greenville, NC 27858-4354 United States
Journal of Cardiovascular Pharmacology (United
States), 1998, 31/6 (904-908)
Garlic and some of its organosulfur components
have been found to be potent inhibitors of
platelet aggregation in vitro. Demonstration of
their efficacy in vivo, however, especially when
administered over extended periods, is sparse. We
recently performed a 10-month study comparing the
effect of aged garlic extract (AGE) with placebo
on the lipid profiles of moderately
hypercholesterolemic men. In the course of the
intervention trial, we examined platelet functions
and susceptibility of lipoproteins to oxidation in
a subgroup of this study population. Study
subjects supplemented with 7.2 AGE per day showed
a significant reduction of epinephrine- and, to a
lesser degree, collagen-induced platelet
aggregation but failed to demonstrate an
inhibition of adenosine diphosphate (ADP)-induced
aggregation. Platelet adhesion to fibrinogen,
measured in a laminar flow chamber at moderately
high shear rate, was reduced by similar30% in
subjects taking AGE compared with placebo
supplement. A trend toward decreased
susceptibility of lipoproteins to oxidation also
was noted during AGE administration compared with
the placebo period. We conclude that the
beneficial effect of garlic preparations on lipids
and blood pressure extends also to platelet
function, thus providing a wider potential
protection of the cardiovascular system.
The
consumer market for functional foods
Gilbert L.
L. Gilbert, HealthFocus, Inc., P.O. Box 7174, Des
Moines, IA 50309-3117 United States
Journal of Nutraceuticals, Functional and Medical
Foods (United States), 1997, 1/3 (5-21)
Major demographic and psychographic shifts in
the consumer market are directing the next stage
evolution of healthy products, sharpening the
marketing focus on healthy products that offer
specific functional health benefits to an aging
population of increasingly savvy consumers.
Because functional food opportunities are largely
consumer-driven, understanding consumer interests
and motivations is key to successfully negotiating
market opportunities for functional foods,
beverages and supplements. The HealthFocus survey
identifies the functional food concerns of key
population segments for companies marketing
functional products who need to identify and
profile the most appropriate target groups.
Dietary
therapy for preventing and treating coronary
artery disease
Masley S.C.
Dr. S.C. Masley, Group Health Coop. of Puget
Sound, Olympia, WA United States
American Family Physician (United States), 1998,
57/6 (1299-1306)
Nearly one half of Americans die of
cardiovascular disease. The morbidity and
mortality associated with coronary artery disease
is strongly related to abnormal lipid levels,
oxidation of lipids and intra-arterial clot
formation. Nutrition powerfully influences each of
these factors. There is growing evidence that
patients can improve lipid levels and decrease the
rate of cardiovascular events by 'adding' specific
foods to their diets and switching from saturated
and polyunsaturated to monounsaturated fats and
n-3 fatty acids. Appropriate dietary changes
decrease arteriosclerotic plaque formation,
improve endothelial vasomotor dynamics, reduce
oxidation of low- density lipoproteins and enhance
thrombolytic activity. Brief discussions between
physicians and patients can influence patients'
food choices. Changes in diet can reduce the
premature mortality and morbidity associated with
coronary artery disease.
Effect
of garlic on some blood lipids and hmgcoa
reductase activity
Merat A.; Fallahzadeh M.
A. Merat, Department of Biochemistry, School of
Medicine, Shiraz Univ. of Med. Sci., Shiraz
Iran
Iranian Journal of Medical Sciences (Iran), 1996,
21/3-4 (141-146)
Triglyceride, total cholesterol, HDL
cholesterol, LDL cholesterol, lipoprotein (a),
free fatty acids and glucose levels were measured
in the serum or plasma of 86 normal male human
subjects, aged 25 to 50 years, before and after
one month of garlic powder consumption (one 400 mg
garlic tablet, 3 times daily). Levels of total
cholesterol, LDL cholesterol and triglycerides
were significantly decreased after garlic
consumption (by 10.7%, 11.5% and 14.2%
respectively, p < 0.05). Furthermore, this
decrease was significantly greater (p < 0.05)
for initial cholesterol levels of > 200 mg/dl
and triglyceride levels of > 150 mg/dl/(14.7%
and 15% respectively), and less pronounced for
cholesterol levels of less than or equal to200
mg/dl and triglyceride levels of less than or
equal to150 mg/dl/(7.3% and 6% respectively). The
reduction in LDL cholesterol was also
significantly greater (p < 0.05) for initial
levels of > 135 mg/dl/(16.7%)as compared with
levels of less than or equal to135 mg/dl/(10.0%).
No significant differences existed in the levels
of glucose, free fatty acids, lipoprotein (a) and
HDL cholesterol measured before and after
consumption of garlic . Measurements of
cholesterol and triglycerides were also carried
out in 15 normal male rats, weighing 250 to 300g,
after receiving a diet containing 2.5% garlic
powder for 10 days. Total cholesterol and
triglyceride levels were significantly lower (p
< 0.05) in these rats as compared to a control
group receiving regular stock powder without
garlic . The specific activity of HMGCoA reductase
in the liver microsomal fraction of 12 normal male
rats receiving the garlic powder (2.5% of the
diet) for 10 days, was also significantly
decreased (p < 0.05) as compared to a control
group on the stock diet without garlic .
Physical performance support with
combined phytotherapy. Ginseng, whitethorn and
mixed pollen combination against stress
Graubaum H.-J.; Metzner C.; Scheider B.
TC Biomed, Abt Umweltmedizin, Etkar-Andre-Str. 8,
12619 Berlin Germany
Therapiewoche (Germany), 1996, 46/25
(1421-1425)
In a randomized, double-blind,
clinically-controlled study, BNK 04, a combination
of active ingredients containing ginseng,
hawthorn, and micronized mixed polled as its main
ingredients, was administered to 18 stressed and
untrained patients (test group: 9 female, 9 male
subjects; mean age = 56,9 years) for 40 days
(first treatment phase). A significant increase in
physical performance (p < 103) as compared to
the control group (10 female, 8 male patients;
mean age = 59,2 years) was detected by means of
bicycle ergometry. The difference between groups
was 20,0%, expressed as the Watt-minute product
(Delta = 207 W x min). Sixteen patients of the
test group underwent a second treatment phase with
BNK 04 (single-blind) following a 4-week washout
phase, during which patients received placebo. At
the onset of the second treatment phase, physical
performance continued to be significantly
increased (p = 0,008) compared to baseline
(11,7%). At the end of treatment, the enhancement
of physical performance was 20,6% combpared to
baseline (p = 0,006). Adverse drug reactions were
not observed. These results demonstrate the
conditioning effect on physical performance of the
active ingredient combination, BNK 04, upon
repeated administration.
Antioxidant of the coronary diet and
disease
Ramon Gimenez J.R.; Alonso M.B.; Rubio S.;
Ramon B.M.; Plaza Celemin L.; Mostaza J.M.; Lozano
I.F.; Fernandez J.M.; Marquez-Montes J.
Gral. Rodrigo, 1, 28003 Madrid Spain
Clinica Cardiovascular (Spain), 1996, 14/2
(29-38)
High levels of cholesterol and Low Density
Lipoproteins (LDL) in plasma are related to high
risk to develop Coronary Heart Disease (CHD).
LDL-chosterol is a primary ingredient of the
atherosclerotic plaque; its accumulation in the
subendothelial space is due to peroxidative
reactions. Natural antioxidants such as carotenes,
polyphenolic flavonoids, vitamin E and C show
defensive properties against lipid peroxidation,
hence it is possible to apply these molecules in
clinical therapy in the prevention of the CHD. On
the other hand, alcohol, and special red wine, as
well as the intake of selenium can afford a
cardioprotective effect. Blood cholesterol
reduction, dietary and/or due to pharmacological
interventions, could modulate lipid peroxidation
through a decreased production of O2.-, pivotal
step in the peroxidative chain of reactions. The
importance of other dietary components (fresh
fruits, nuts, garlic and other vegetables as well
as olive oil) have been analyzed to assess its
influence and protective action in the prevention
of CHD.
Satellite symposium 'International
Garlic Research'
Reuter H.D.
Siebengebirgsallee 24, 50939 Koln Germany
Zeitschrift fur Phytotherapie (Germany), 1996,
17/1 (13-25)
The reports of the satellite symposium
'International Garlic Research' presented recent
results of garlic research. Pharmacological
investigations showed that the vessel-dilatating
effect of garlic powder extracts, allicin and
ajoen is mediated by opening K+-channels and by
membrane hyperpolarization. It could be shown that
garlic powder directly affects cholesterol
-accumulation by LDL and that there exists an
inverse correlation between LDL-atherogenicity and
sialic acid content of LDL. By garlic powder in
hyperlipidemic patients the decreased sialic acid
level could be normalized. Garlic constituents
influence cholesterol biosynthesis on several
levels. With respect to the late steps of
cholesterol biosynthesis the inhibition of
lanosterol 14-demethylase by allicin and ajoene
was most important. Garlic also influences nitric
oxide metabolism by increasing the blood levels of
NO. Insufficient synthesis of NO in the blood may
result in hypertension, angina pectoris and
impotentia. A metaanalysis of clinical trials with
garlic powder preparations proves their effects on
blood pressure and lipid levels. A comparative
trial of the effects of garlic powder and garlic
oil bas shown, that powder preparations have a
stronger lipid-lowering effect than
oil-preparations, while blood pressure is affected
by powder preparations only. Another study showed
that supplementation of a fish oil medication with
garlic abolishes the fish-oil-induced increase of
LDL-cholesterol levels and lowers the
LDL-cholesterol levels. Finally the preliminary
evaluation of an epidemiological study indicates
that there are hints of a decreased stiffness of
the aorta in humans with regular intake of a
garlic powder preparation while another trial
reveals a significant reduction of the extention
of atheromateous plaques by garlic powder.
Garlic
in hyperlipidemia. Influence of a garlic
preparation on the lipid serum levels of patients
with primary hyperlipidaemia
Schiewe F.P.; Hein T.
Naturheilverfahren, Zorgiebelstr. 10-12, 50767
Koln Germany
Zeitschrift fur Phytotherapie (Germany), 1995,
16/6 (343-348)
The lipid lowering effect of an enteric coated
garlic /cyclodextrine preparation (Tegra (R)) was
investigated. 97 patients with known primary
hyperlipidaemia (serum levels of total cholesterol
exceeding 260 mg/100 ml) took part in this trial.
Patients received 10 mg/day of essential garlic
oil obtained by steam distillation of garlic . The
trial was carried out of 3 months and for 6 months
in those cases in which the aim of the treatment
(reduction of serum levels of total cholesterol to
values less than 260 mg/100 ml) had not been
reached after 3 months. Most of the patients did
not alter their diet, though they were advised to
do so. In 28 of 97 patients the treatment was
successful after 3 months. The total cholesterol
(TC) decreased by 7.8% from 287 to 264 mg/100 ml
in the mean, the triglycerides (TG) by 2.2% from
205 to 180 mg/100 ml, the low-density lipoprotein
cholesterol (LDL-C) by 10.2% from 207 to 186
mg/100 ml. The high-density lipoprotein
cholesterol (HDL-C) increased by 10% from 38.8 to
42.6 mg/100 ml. Continuing the trial for a further
three months in 69 patients resulted in an overall
reduction of TC by 14.1% to 246 mg/100 ml, of TG
by 20.2% to 164 mg/100 ml, and of LDL-C by 18.8%
to 168 mg/100 ml. HDL-C values in the same time
increased by 17.6% to 45.6 mg/100 ml. All changes
were statistically significant (p < 0.001). The
aim of the treatment was reached by 90% of the
patients (87 of 97). All patients had a reduction
of TC, TG and LDL-C and an increase in HDL-C. No
severe side effects were observed. The results of
the study demonstrate the efficacy of essential
garlic oil/beta-cyclodextrine complexes in the
treatment of hyperlipidaemia.
Therapeutic actions of garlic
constituents
Agarwal K.C.
Dept. of Mol. Pharm./Biotechnology, Brown
University School of Medicine, Providence, RI
02912 USA
Medicinal Research Reviews (USA), 1996, 16/1
(111-124)
Most studies on garlic during the past 15 years
have been primarily in the fields of
cardiovascular and cancer research. Cardiovascular
studies have been mainly related to
atherosclerosis, where effects were examined on
serum cholesterol, LDL, HDL, and triglycerides.
Although the studies were not consistent in
relation to the dosage, standardization of garlic
preparations, and period of treatment, most
findings suggest that garlic decreases cholesterol
and triglycerides levels in patients with
increased levels of these lipids. Lowering of
serum lipids by garlic ingestion may decrease the
atherosclerosis process. The other major
beneficial effect of garlic is due to its
antithrombotic actions. This field of garlic
research has been extensively studied. Garlic
extracts and several garlic constituents
demonstrate significant antithrombotic actions
both in vitro and in vivo systems. Allicin and
adenosine are the most potent antiplatelet
constituents of garlic because of their in vitro
effects. Since both allicin and adenosine are
rapidly metabolized in human blood and other
tissues, it is doubtful that these compounds
contribute to any antithrombotic actions in the
body. In addition, ajoene also seems not to be an
active antiplatelet principle, because it is not
naturally present in garlic, garlic powders, or
other commercial garlic preparations. Only a small
amount of ajoene can be found in garlic
oil-macerates; however, ajoene is being developed
as a drug for treatment of thromboembolic
disorders. Recent findings on the identification
of potent enzyme inhibiting activities of
adenosine deaminase and cyclic AMP
phosphodiesterase in garlic extracts are
interesting, and may have a significant role in
the pharmacological actions in the body. Presence
of such enzyme inhibitors in garlic may perhaps
explain several clinical effects in the body,
including the antithrombotic, vasodilatory, and
anticancer actions. Epidemiological studies have
suggested that garlic plays a significant role in
the reduction of deaths caused by malignant
diseases. This had led many investigators to
examine garlic and garlic constituents for their
antitumor and cytotoxic actions both in vitro and
in laboratory animals. The data from these
investigations suggest that garlic contains
several potentially important agents that possess
antitumor and anticarcinogenic properties. In
summary, the epidemiological, clinical, and
laboratory data have proved that garlic contains
many biologically and pharmacologically important
compounds, which are beneficial to human health
from cardiovascular, neoplastic, and several other
diseases. Numerous studies are in progress all
over the world to develop effective and odorless
garlic preparations, as well as to isolate the
active principles that may be therapeutically
useful.
Towards
the control of the hypertension epidemic. The
Philippine experience
Abarquez R.F. Jr.
Philippine Heart Center, East Avenue, Quezon City
Philippines
Philippine Journal of Internal Medicine
(Philippines), 1995, 33/2 (33-35)
As of 1990 the Philippines is 2nd to Indonesia
in hypertensive-related mortality. To reverse this
trend, hypertension control strategies involve
health provider and client perceptions of the
issues. A recent Philippine Society of
Hypertension (PSH) survey which included pooled
historical data of 25,427 respondents showed 15%
clinical practice hypertension prevalence. Most
initial work-up includes ECG, urinalysis,
cholesterol and sugar blood levels and chest x-ray
examinations. Antihypertensive monotherapy
preferences were calcium antagonists (25%),
betablockers (8%), and diuretics (7%). Client
awareness of being hypertensive is 52% with only
23% admitting good BP control. Almost 60% are
asymptomatic at hypertension discovery. Role of
diabetes, pregnancy, renal and eye problems in
hypertension obtained low perception. Use of
garlic and cleansing diet were perceived to be
beneficial in BP control despite lack of
documentation. Antihypertensive medication
compliance was 33% in industrial patients compared
to 51% in the general population. From this pooled
survey data, programs and strategies will emerge
in order to control the hypertension epidemic. A
clear message seems obvious - it is wrong to
assume that a patient understands a doctor's
explanation readily.
How
does garlic exert its hypocholesterolaemic action?
The tellurium hypothesis
Larner A.J.
University of Cambridge, Department of Anatomy,
Downing Street, Cambridge CB2 3DY United
Kingdom
Medical Hypotheses (United Kingdom), 1995, 44/4
(295-297)
The efficacy of garlic as a lipid-lowering
agent is being increasingly recognized, but the
biochemical mechanisms underlying this action are
currently unknown. It is proposed that organic
tellurium compounds, which are found in high
concentration in fresh garlic buds, may contribute
to this action by inhibiting squalene epoxidase,
the penultimate enzyme in the synthetic pathway of
cholesterol . Weanling rats fed a diet rich in
tellurium develop a demyelinating polyneuropathy
due to inhibition of this enzyme in peripheral
nerves. Chronic exposure to small amounts of
tellurium found in garlic might reduce endogenous
cholesterol production through inhibition of
hepatic squalene epoxidase and so reduce
cholesterol levels. Tellurium may also contribute
to the characteristic odour of garlic since the
most obvious clinical sign of tellurium poisoning
is a garlic -like odour.
Efficacy of dietary recommendations
and phytotherapy with Allium sativum in mild and
moderate hypercholesterinemia
Walper A.; Rassoul F.; Purschwitz K.; Schulz
V.
Lichtwer Pharma GmbH, Wallenroder Strasse 8-10,
D-13435 Berlin Germany
Med. Welt (Germany), 1994, 45/7-8 (327-323)
Within a primary lipid screening including 9251
persons a group of 8001 subjects (65% women, 35%
men) with a serum level of 221 -300 mg/dl total
cholesterol are recommended a diet with low fat
and cholesterol content during 6-8 weeks. The
'nonresponder' received by continuous diet 600
mg/die of Allium sativum. After the period with
diet alone the mean serum cholesterol level
decrease was 3 mg/dl, after the next weeks with
additional application of garlic powder a decrease
of 6 mg/dl was measured. Short time dietary
recommendations alone are not as succesful as a
diet connected with application of standardized
garlic powder. With a good compliance the effect
of diet on serum cholesterol level is supported by
phytotherapy.
Dyslipidemias and the secondary
prevention of coronary heart disease
Rosenson R.S.; Frauenheim W.A.; Tangney C.C.
Department of Medicine and Pathology, Preventive
Cardiology Center, Rush University, Chicago, IL
USA
Dis. Mon. (USA), 1994, 40/8 (373-462)
Dyslipidemias in patients with coronary heart
disease confer a greater risk of ischemic cardiac
events than comparable dyslipidemias in people
free of disease. A major dyslipidemia can be
diagnosed in more than 80% of patients with
established premature coronary heart disease.
These dyslipidemias constitute not only elevations
of low-density lipoprotein cholesterol
(hypercholesterolemia) but also indicate
abnormalities in the metabolism of
triglyceride-rich lipoproteins, high-density
lipoproteins, and lipoprotein(a). Clinical trials
have demonstrated that therapy to lower low-
density lipoprotein levels can delay angiographic
progression of coronary stenoses and reduce
recurrent cardiac event rates. These clinical
benefits from low-density lipoprotein cholesterol
lowering may occur as early as 6 to 12 months
after initiation of therapy. Intervention
strategies for dyslipidemias are directed toward
lowering the low-density lipoprotein cholesterol
fraction to 90 to 100 mg/dl. This approach begins
with dietary modification, weight loss, smoking
cessation, and aerobic exercise. Patients with
hypercholesterolemia refractory to
nonpharmacologic intervention require
lipid-lowering agents. The choice of
lipid-lowering medications is influenced by
concomitant abnormalities of lipoprotein
metabolism, such as hypertriglyceridemia or
hypoalphalipoproteinemia. Treatment of primary
dyslipidemias other than hypercholesterolemia may
be warranted in the presence of other cardiac risk
factors; however, a broader spectrum of clinical
trial data is needed to support or refute this
contention.
Effect
of garlic powder tablets on blood lipids and blood
pressure - A six month placebo controlled, double
blind study
De A. Santos O.S.; Grunwald J.
Lichtwer Pharma GmbH, Drewitzer Strasse 10, 1000
Berlin 28 Germany
Br. J. Clin. Res. (United Kingdom), 1993, 4/-
(37-44)
In a double blind, placebo controlled
randomised study the effects of a standardised
garlic powder tablet (Kwai(*), Lichtwer Pharma) on
blood lipids and blood pressure was investigated.
A total of 52 out-patients with total cholesterol
values over 6.5 mmol/l took part in the study.
Patients were randomly allocated to take tablets
containing a total of 900 mg garlic powder
(standardised to 1.3% alliin) daily or the same
number of placebo tablets for six months. All
patients were advised to follow a low fat/
cholesterol diet. Blood lipids were measured at
baseline and after three and six months treatment.
Blood pressure and well-being were assessed in
monthly intervals. The baseline mean for serum
total cholesterol of 6.92 mmol/l was reduced to
6.31 mmol/l after six months of garlic powder
tablet treatment. Corresponding values for placebo
were 7.05 mmol/l before and 6.74 mmol/l after
placebo treatment. The difference between active
treatment and placebo is statistically significant
(p < 0.05). The mean values for low density
lipoprotein cholesterol (LDL-C) was reduced by
nearly 10% by garlic and by 6% by placebo. Mean
systolic blood pressure (SBP) remained unchanged
in the placebo group and was reduced in the active
treated group by 17% from 145 to 120 mmHg (p <
0.001). Mean diastolic blood pressure (DBP)
remained unchanged in the placebo group and was
reduced in the active treated group from 90 mmHg
to 80 mmHg (p < 0.01). The differences between
active and placebo treatment were significant
after two months of treatment for DBP and after
four months for SBP. Well-being, as analysed by a
five-point score system, remained unchanged in the
placebo group and was improved in the active
treated group by 20% (p < 0.001).
Garlic
supplementation and lipoprotein oxidation
susceptibility
Phelps S.; Harris W.S.
Lipid Laboratory, KU Medical Center, 3800
Cambridge St., Kansas City, KS 66160 USA
Lipids (USA), 1993, 28/5 (475-477)
Interventions which make serum lipoproteins
less susceptible to oxidation may be
antiatherogenic. The antioxidant properties of
garlic which have been demonstrated in vitro led
us to investigate the effects of garlic
supplements on lipoprotein oxidation
susceptibility in humans. Ten healthy volunteers
were given 600 mg/d of garlic powder (6 tablets of
Kwai (R)) for two weeks in a placebo-controlled,
randomized, double-blind crossover trial. We found
that although serum lipid and lipoprotein levels
were not lowered in this short time period, the ex
vivo susceptibility of apolipoprotein B-containing
lipoproteins to oxidation was significantly
decreased (-34%). Because garlic has been reported
to beneficially affect serum lipid levels,
platelet function, fibrinolysis and blood
pressure, this additional effect of retarding
lipoprotein oxidation may contribute to the
potential antiatherosclerotic effect of garlic
.
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