Garlic for Hypertension

Introduction
Garlic, also known as Allium sativum, is an edible bulb from a plant in the lily family that is native to
Siberia.1,2 Garlic is used widely as a flavoring in cooking. Throughout the history, garlic has been used to
treat bronchitis, hypertension, tuberculosis, liver disorders, intestinal worms, diabetes, and fevers.3
Currently, garlic is used as a dietary supplement for hypertension, high cholesterol, and common cold.1

What is hypertension?
Hypertension is a condition where the blood pressure is consistently too high.4 Blood pressure is recorded
as two numbers: systolic blood pressure (first number) and diastolic blood pressure (second number).
Systolic blood pressure represents the pressure of the blood against the artery walls as the heart beats.5
On the other hand, diastolic pressure is the pressure of the blood against the artery walls while the heart
is resting between beats.5 Blood pressures of less than 120/80 mmHg are considered normal. When the
blood pressure goes above 130/80 mmHg, that is considered hypertension.

Hypertension increases the workload of the heart and blood vessels.4 Over time, this damages the tissues
inside the arteries.4 If left untreated or uncontrolled, hypertension can lead to heart attack, stroke, or
even death. Hypertension usually has no symptoms, so getting the blood pressure measured is the only
way to know if you have it. Many prescription medications are available for the treatment of hypertension.

How does garlic lower blood pressure?

It is not completely understood how garlic works in the body. Garlic produces a chemical called allicin.
Allicin is thought to be responsible for lowering blood pressure.2 Garlic may increase a chemical in the
body called nitric oxide, which relaxes and dilates the blood vessels. This allows blood to flow more freely,
thus lowering the blood pressure.6

There have been numerous studies done on garlic and how it affects the blood pressure. A 2010
randomized controlled trial assessed the effect of aged garlic extract as an additional therapy in patients
who have uncontrolled hypertension despite taking hypertension prescription medications.7 The
participants were given either aged garlic extract 960 mg daily for 12 weeks or placebo daily for 12 weeks.
The average systolic blood pressure decreased by 10.2 mmHg in the garlic group, in comparison to the
placebo group.

A 2016 study investigated the effect of aged garlic extract on blood pressure and other cardiovascular risk
factors in patients with uncontrolled hypertension.8 The study participants were randomly assigned to
aged garlic extract 1.2 g daily for 12 weeks or placebo daily for 12 weeks. In the garlic group, the average
systolic blood pressure was significantly reduced by 11.5 mmHg. And, the average diastolic blood pressure
was reduced by 6.3 mmHg.

A meta-analysis done in 2016 reviewed 20 clinical trials on the effect of garlic supplements on blood
pressure.9 Overall, the average systolic blood pressure decreased by 5.1 mmHg and the average diastolic
blood pressure decreased by 2.5 mmHg. In participants with blood pressures ≥ 140/90 mmHg at the start
of the clinical trials, greater reductions in systolic blood pressure (by 8.7 mmHg) and diastolic blood
pressure (by 6.1 mmHg) were observed.
Lastly, a recent review and meta-analysis published in 2020 looked at 12 clinical trials on the effect of
garlic on blood pressure in people with hypertension.10 Garlic reduced the systolic blood pressure by an
average of 8.3 mmHg and the diastolic blood pressure by an average of 5.5 mmHg, which were very similar
to the reductions by the standard hypertension prescription medications. This reduction in blood pressure
was associated with a 16-40% reduction in the risk of developing heart disease.

How do you take garlic?

The garlic supplement is made from the bulb of the garlic plant.1 The supplement is available as tablets,
capsules, and topical oil.1 Garlic is not approved as a drug by the Food and Drug Administration (FDA). It
can be challenging to determine how much garlic to consume as there are no official recommended
dosages. It is recommended to start with a low dosage and increase slowly until the desired effect is
reached. Prior to using garlic, have a discussion with your doctor to make sure it is appropriate to use.

Safety of garlic
Garlic is generally well tolerated. Most common side effects are bad breath, body odor, heartburn, and
upset stomach.1,2 Garlic may cause an increase in the bleeding risk. There have been reports of bleeding
after surgery in people taking garlic.2 The safety of garlic during pregnancy and lactation has not been well
studied.2

Garlic does not have serious interactions with any medications. It may reduce the level of isoniazid (a
tuberculosis medication) in the body, leading to the decreased effectiveness of isoniazid.2 Garlic may also
increase the rate of breakdown of some HIV/AIDS drugs, so they are not as effective in treating HIV/AIDS.2
In addition, garlic interacts with oral contraceptives and anticoagulants/antiplatelets.2 It may reduce the
level of estrogens in the body, reducing the effectiveness of oral contraceptives.2 It slows blood clotting.
So, taking garlic with anticoagulants (e.g. warfarin, heparin, Lovenox, Eliquis, Xarelto) or antiplatelets (e.g.
aspirin, Plavix) may increase the risk of bleeding.2

Conclusion
Garlic is currently used as a dietary supplement for hypertension. It works in the body by increasing a
chemical in the body called nitric oxide. This causes relaxation and dilation of blood vessels, leading to the
lowering in blood pressure. Study findings showed that garlic lowered blood pressure in people with
hypertension. Before using garlic for hypertension, please consult your doctor to determine that it is safe
and appropriate for you.
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References:
1. “Garlic.” National Center for Complementary and Integrative Health.
https://www.nccih.nih.gov/health/garlic. Sept. 2016. Accessed Oct. 22, 2020.
2. “Garlic.” WebMD. https://www.webmd.com/vitamins/ai/ingredientmono-300/garlic. Accessed
Oct. 22, 2020.
3. “What are the benefits of garlic?” Medical News Today.
https://www.medicalnewstoday.com/articles/265853. Aug. 18, 2017. Accessed Oct. 23, 2020.
4. “What is High Blood Pressure?” American Heart Association. https://www.heart.org/en/health-
topics/high-blood-pressure/the-facts-about-high-blood-pressure/what-is-high-blood-pressure.
Oct. 13, 2016. Accessed Oct. 23, 2020.
 5. “Understanding Blood Pressure Readings.” American Heart Association.
https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-
readings. Oct. 23, 2020.
6. Ried, Karin, and Peter Fakler. “Potential of garlic (Allium sativum) in lowering high blood
pressure: mechanisms of action and clinical relevance.” Integrated blood pressure control vol. 7
71-82. 9 Dec. 2014, doi:10.2147/IBPC.S51434
7. Ried, Karin et al. “Aged garlic extract lowers blood pressure in patients with treated but
uncontrolled hypertension: a randomised controlled trial.” Maturitas vol. 67,2 (2010): 144-50.
doi:10.1016/j.maturitas.2010.06.001
8. Ried, Karin et al. “The effect of aged garlic extract on blood pressure and other cardiovascular
risk factors in uncontrolled hypertensives: the AGE at Heart trial.” Integrated blood pressure
control vol. 9 9-21. 27 Jan. 2016, doi:10.2147/IBPC.S93335
9. Ried, Karin. “Garlic Lowers Blood Pressure in Hypertensive Individuals, Regulates Serum
Cholesterol, and Stimulates Immunity: An Updated Meta-analysis and Review.” The Journal of
nutrition vol. 146,2 (2016): 389S-396S. doi:10.3945/jn.114.202192
10. Ried, Karin. “Garlic lowers blood pressure in hypertensive subjects, improves arterial stiffness
and gut microbiota: A review and meta-analysis.” Experimental and therapeutic medicine vol.
19,2 (2020): 1472-1478. doi:10.3892/etm.2019.8374

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