Garlic and Hypertension: Efficacy, Mechanism of Action, and Clinical Implications
Abstract
:1. Introduction
2. Historical Use of Garlic in Traditional Medicine
3. Garlic’s Broader Historical Uses
4. Traditional Beliefs about Garlic Use
5. Attitudes toward Supplementary Herbal Therapy in Hypertension
6. Phytochemical Composition of Garlic
7. Mechanisms of Action
- Oxidative Stress
- b.
- Nuclear Factor Kappa B (NF-κB)
- c.
- Hydrogen Sulfide (H2S)
- d.
- Nitric Oxide (NO)
- e.
- Renin–Angiotensin–Aldosterone System (RAAS)
- f.
- Vascular Smooth Muscle Cells (VSMCs)
Biological Factors | Physiologic Effect | Action of Garlic and Its Components |
---|---|---|
Oxidative stress | Oxidative stress can lead to endothelial dysfunction and the inability to promote vasodilation, fibrinolysis, and anti-aggregation [49]. | SAC can trap ROS and lower the activity of NADPH oxidase. AG increases the activity of superoxide dismutase. Allicin scavenges free radicals and traps OH. Both SAC and Allicin reduce Angiotensin II-induced ROS formation [5]. |
NF-κB | NF-κB can activate genes that produce pro-inflammatory cytokines like tumor necrosis factor-alpha (TNF-α) and interleukin-1 (IL-1). These cytokines can cause inflammation in the blood vessels, which contributes to endothelial dysfunction [50]. | Pyrrolidine dithiocarbamate and SAC suppress NF-κB, which is elevated, along with ROS, in SHRs [5]. |
H2S | H2S was shown to induce vasodilation and reduce blood pressure [51]. | Garlic enhances H2S production by the catalytic effect of CSE [5]. Garlic-derived polysulfides stimulate H2S and enhance NO regulation [6,30]. |
NO | NO is a potent vasodilator and regulator of vascular tone. It helps to maintain low arterial pressure, inhibit platelet aggregation, and prevent smooth muscle cell proliferation [52]. | Garlic increases NO bioavailability and reduces the generation of ROS, such as O2−, which tends to consume NO [5,32,33]. Garlic supplementation can block L-NAME-induced hypertension by promoting NO synthesis [34]. |
RAAS | The RAAS regulates blood pressure and fluid balance. An overactive RAAS leads to hypertension [53]. | SAC and captopril synergistically inhibit ACE in guinea pigs and decrease blood pressure in rats [38]. Garlic and allicin inhibit epithelial Na channels, which leads to less sodium and water retention and a higher urine sodium concentration [5]. |
VSMCs | VSMCs regulate vascular tone and blood pressure. Changes in the function or phenotype of VSMCs can contribute to the development of hypertension [32]. | Garlic, AMS, and DAS interrupt the G0/G1 cell cycle phase and reduce EFK phosphorylation, which leads to decreased VSMC proliferation [5,41,42]. In addition, opening KATP channels by H2S and exogenous H2S donors induces systemic vasodilation [4]. |
8. Garlic’s Interaction with Antihypertensive Drugs as a Co-Administered Therapy
9. Clinical Studies on Garlic and Hypertension
- Blood Pressure Reduction
- b.
- Cholesterol Impact
10. Studies on Specific Garlic Formulations
- Aged Black Garlic Extract
- b.
- Time-Released Garlic Powder Tablets
- c.
- Raw Crushed Garlic
11. Garlic-Protein-Derived Novel Angiotensin I-Converting Enzyme Inhibitory Peptides from MDR and HDCF
- Introduction and Mechanism of Action
- b.
- Effect on Body Weight and Organ Coefficients
- c.
- Effect on Blood Pressure
12. Additional Considerations and Limitations
- Long-Term Effects
- b.
- Garlic Form Matters
- c.
- Dosage and Delivery
- d.
- Drug Interactions
- e.
- Importance of Patient Education
13. Allergies and Adverse Effects
- Garlic Allergy
- b.
- Garlic-Induced Gastroenteritis and Esophagitis
- c.
- Safety and Potential Toxicity Related to Sulfoxide Compounds
14. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Sleiman, C.; Daou, R.-M.; Al Hazzouri, A.; Hamdan, Z.; Ghadieh, H.E.; Harbieh, B.; Romani, M. Garlic and Hypertension: Efficacy, Mechanism of Action, and Clinical Implications. Nutrients 2024, 16, 2895. https://doi.org/10.3390/nu16172895
Sleiman C, Daou R-M, Al Hazzouri A, Hamdan Z, Ghadieh HE, Harbieh B, Romani M. Garlic and Hypertension: Efficacy, Mechanism of Action, and Clinical Implications. Nutrients. 2024; 16(17):2895. https://doi.org/10.3390/nu16172895
Chicago/Turabian StyleSleiman, Christopher, Rose-Mary Daou, Antonio Al Hazzouri, Zahi Hamdan, Hilda E. Ghadieh, Bernard Harbieh, and Maya Romani. 2024. "Garlic and Hypertension: Efficacy, Mechanism of Action, and Clinical Implications" Nutrients 16, no. 17: 2895. https://doi.org/10.3390/nu16172895