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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unpublished randomised controlled trials of garlic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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