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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placebo and other lipid lowering agents, a systematic review, including meta-analysis, was undertaken of published and unpublished randomised controlled trials of garlic preparations of at least four weeks' duration.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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