Scientific Name: Alliaceae, Allium sativum, or Liliaceae. 

Family Amaryllidaceae, Alliaceae, or Liliaceae 

Other Common Names: Aged Black Garlic Extract, Aged Garlic Extract, Ail, Ail Blanc, Ail Cultive, Ail Rocambole, Ajo, Alho, Allii Sativi Bulbus, Allium, 

Overview

Garlic is an herb cultivated worldwide with a long history of culinary and medicinal use. It is related to onions, leeks, and chives. It is thought that garlic is native to Siberia, but was spread to other parts of the world over 5000 years ago. Garlic has been traditionally used for diphtheria, cough, fever, bites and stings, and hemorrhoids. 

Likely Safe when used orally and appropriately. Garlic has been used safely in clinical studies lasting up to 7 years without reports of significant toxicity Possibly Safe when used topically. Garlic-containing gels, lipid-soluble garlic extracts, garlic pastes, and garlic mouthwashes have been safely used in clinical research for up to 3 months...when used intravaginally. A vaginal cream containing garlic and thyme has been safely used nightly for 7 nights. 

Possibly Unsafe when raw garlic is used topically (585). Raw garlic might cause severe skin irritation when applied topically. 

CHILDREN: Possibly Safe when used orally and appropriately for up to 8 weeks. Garlic extract 300 mg three times daily has been used with apparent safety for up 8 weeks in children ages 8-18 years (4796). There is insufficient reliable information available about the safety of garlic when used over longer durations or in higher doses. 

CHILDREN: Possibly Unsafe when raw garlic is used topically. Raw garlic might cause severe skin irritation when applied topically 

PREGNANCY: Likely Safe when used orally in amounts commonly found in foods 

PREGNANCY: Possibly Unsafe when used orally in medicinal amounts. Garlic is reported to have abortifacient activity. One study also suggests that garlic constituents are distributed to the amniotic fluid after a single dose of garlic. However, there are no published reports of garlic adversely affecting pregnancy. In clinical research, garlic 800 mg daily was used during the third trimester of pregnancy with no reported adverse outcomes. There is insufficient reliable information available about the safety of topical garlic during pregnancy. 

LACTATION: Likely Safe when used orally in amounts commonly found in foods. 

LACTATION: Possibly Unsafe when used orally in amounts greater than those found in foods. Several small studies suggest that garlic constituents are secreted in breast milk, and that nursing infants of mothers consuming garlic are prone to extended nursing. There is insufficient reliable information available about the safety of topical garlic during lactation. 

General 

Orally, garlic is generally well tolerated. Topically, garlic seems to be well tolerated. Intravenously, there is insufficient reliable information available about adverse effects.

Most Common Adverse Effects 

Orally: Abdominal pain, body odor, flatulence, malodorous breath, and nausea. Allergic reactions in sensitive individuals.
 

Topically: Burns and dermatitis with fresh garlic. 

Serious Adverse Effects (Rare) 

Orally: Some case reports raise concerns about increased risk of bleeding with garlic.

Most clinical research suggests that oral garlic, taken alone or in combination with metformin for at least 12 weeks, modestly reduces fasting blood glucose levels in patients with diabetes. It is unclear if garlic improves postprandial glucose levels or glycated hemoglobin (HbA1c).

Endometriosis. 

Oral garlic seems to improve pain in people with endometriosis.

Hyperlipidemia. 

Most research shows that taking oral garlic for at least 8 weeks seems to modestly reduce total and low-density lipoprotein (LDL) cholesterol and slightly increase high-density lipoprotein (HDL) cholesterol in patients with hyperlipidemia. However, evidence is conflicting on whether garlic reduces triglyceride levels.

Hypertension. 

Some clinical research suggests that oral garlic seems to modestly reduce blood pressure in hypertensive and normotensive patients.

Nonalcoholic fatty liver disease (NAFLD). 

Oral garlic seems to reduce the severity of hepatic steatosis in patients with NAFLD.

Periodontitis. 

Oral aged garlic extract seems to improve some measures of gum health in people with mild to moderate periodontitis.

Adult Dosage

Oral:

Garlic has most often been used in doses of 2400 mg daily for 12 months. See Effectivenesssection for condition-specific information.
 

Garlic extract is often standardized to allicin content, with concentrations in most formulations ranging from 1.1% to 1.3% (731, 4782, 4786, 4788, 4789, 4795, 4796, 4798, 6457, 6897)(51250, 51343, 51590, 51598, 107239).

Topical:

Garlic has been used in various topical formulations, including as a cream, gel, paste, ointment, and mouthwash. See Effectivenesssection for condition-specific information.

Standardization & Formulation

Many garlic products, including garlic powder, garlic oil, and garlic extract, are standardized to allicin content. Tablets containing enteric-coated Australian garlic powder have been standardized to provide 2.4 mg allicin per 220 mg garlic powder (51250). A specific garlic powder tablet (Garlet) has been standardized to contain allicin 1000-1200 mcg per 400 mg of dried powder garlic (9201, 51467). Some specific garlic powder products, including Kwai (Lichtwer Pharma) and Garlex (Bosch Pharmaceuticals), have been standardized to contain 1.3% allicin (731, 4782, 4786, 4788, 4789, 4795, 4796, 4798, 6457, 6897)(51343, 51590, 51598).
 

Garlic oil has also been standardized to allicin content. In clinical research, garlic oil 275 mg was standardized to contain 800 mcg allicin (4763). A specific product containing steam-distilled garlic oil (Tegra, Hermes Arzneimittel GmbH) 5 mg (equivalent to 4-5 grams of fresh garlic cloves) has been standardized to contain 4000 units of allicin (732).
 

Some garlic extract products have also been standardized to allicin content. Tablets containing enteric-coated Thai garlic extract have been standardized to contain 1.12% allicin (15296).
 

Garlic is also available as aged garlic extract, which refers to extracts produced from aged garlic bulbs soaked in water or ethanol. Alternatively, black garlic (also referred to as aged black garlic) is produced by exposing fresh garlic bulbs to high temperatures and controlled humidity for several weeks to months. These aging processes are associated with biochemical changes, including the decomposition of alliin and allicin, which leads to the production of S-allyl-L-cysteine and an increase in polysulfides (i.e., diallyl sulfide, diallyl disulfide, diallyl trisulfide, dithiins, and ajoene). Aged garlic and black garlic extracts differ in amounts of furfurals and organosulfur compounds (108607).
 

A specific product containing aged garlic extract (Kyolic, Garlic High Potency Everyday Formula 112, Wakunaga/Wagner) 240 mg (equivalent to 625 mg of fresh garlic) has been standardized to contain 0.6 mg of S-allyl-L-cysteine (51442, 88398). One specific aged black garlic extract product (ABG+; PharmActive Biotech Products) prepared using a proprietary aging process has been standardized to contain a minimum of S-allyl-L-cysteine 0.1% (108607).

ANTICOAGULANT/ANTIPLATELET DRUGS 

Interaction Rating Moderate:  Be cautious with this combination.

Severity HIGH

Occurrence POSSIBLE

Level of Evidence D (Theoretical based on pharmacology) 

Garlic may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

ANTIDIABETES DRUGS 

Interaction Rating Moderate Be cautious with this combination.

Severity MODERATE

Occurrence POSSIBLE

Level of Evidence B (Lower quality RCT) 

Theoretically, taking garlic with antidiabetes drugs might increase the risk of hypoglycemia.

ANTIHYPERTENSIVE DRUGS 

Interaction Rating Moderate Be cautious with this combination.

Severity HIGH

Occurrence POSSIBLE

Level of Evidence D (Theoretical based on pharmacology) 

Theoretically, taking garlic with antihypertensive drugs might increase the risk of hypotension.

ATAZANAVIR (Reyataz) 

Interaction Rating Moderate Be cautious with this combination.

Severity HIGH

Occurrence POSSIBLE

Level of Evidence D (Anecdotal evidence) 

Theoretically, garlic might decrease levels and effects of atazanavir.

CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES 

Interaction Rating Moderate Be cautious with this combination.

Severity MODERATE

Occurrence PROBABLE

Level of Evidence B (Lower quality RCT) 

Garlic might increase levels of drugs metabolized by CYP2E1.

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES 

Interaction Rating Moderate Be cautious with this combination.

Severity MODERATE

Occurrence POSSIBLE

Level of Evidence B (Nonrandomized clinical trial) 

Theoretically, garlic products containing allicin might induce intestinal CYP3A4 and inhibit hepatic CYP3A4. This may increase or decrease levels of drugs metabolized by CYP3A4.

ISONIAZID 

Interaction Rating Moderate Be cautious with this combination.

Severity HIGH

Occurrence POSSIBLE

Level of Evidence D (In vitro or animal study) 

Theoretically, garlic might decrease levels of isoniazid.

PROTEASE INHIBITORS (PIs) 

Interaction Rating Moderate Be cautious with this combination.

Severity HIGH

Occurrence POSSIBLE

Level of Evidence B (Nonrandomized clinical trial) 

Theoretically, garlic products containing allicin might decrease levels of PIs.

SAQUINAVIR (Fortovase, Invirase) 

Interaction Rating Moderate Be cautious with this combination.

Severity HIGH

Occurrence POSSIBLE

Level of Evidence B (Nonrandomized clinical trial) 

Theoretically, garlic containing allicin might decrease levels of saquinavir.

SOFOSBUVIR (Sovaldi) 

Interaction Rating Moderate Be cautious with this combination.

Severity MODERATE

Occurrence POSSIBLE

Level of Evidence D (In vitro or animal study) 

Theoretically, taking garlic with sofosbuvir might decrease its effectiveness.

TACROLIMUS (Prograf) 

Interaction Rating Moderate Be cautious with this combination.

Severity HIGH

Occurrence POSSIBLE

Level of Evidence B (Case-control study) 

Theoretically, garlic might increase levels of tacrolimus.

WARFARIN (Coumadin) 

Interaction Rating Moderate Be cautious with this combination.

Severity HIGH

Occurrence POSSIBLE

Level of Evidence D (Anecdotal evidence) 

Theoretically, garlic might increase the risk of bleeding with warfarin.

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ANTICOAGULANT/ANTIPLATELET HERBS AND SUPPLEMENTS 

Theoretically, garlic may have antiplatelet effects.

HERBS AND SUPPLEMENTS WITH HYPOGLYCEMIC POTENTIAL 

Theoretically, garlic might have hypoglycemic effects.

HERBS AND SUPPLEMENTS WITH HYPOTENSIVE EFFECTS 

Theoretically, garlic might have hypotensive effects.

| 

BLEEDING DISORDERS 

PERIOPERATIVE None known. 

There is limited information available about the presentation of overdose with garlic. In one case report, an acute myocardial infarction occurred in a 23-year-old man with no known history of cardiac disease or other known risk factors after he consumed a large amount of garlic .

There is insufficient reliable information available about the treatment of overdose with garlic.

Allicin and other garlic constituents, including S-allyl cysteine and gamma-glutamyl-cysteine, are well absorbed . Garlic compounds are rapidly absorbed through mucous membranes and skin.

The garlic constituent S-allyl cysteine is metabolized in the liver and kidneys. Metabolites of garlic include allicin (active), ALMA (N-acetyl-S-allyl-L-cysteine or allyl mercapturic acid), diallyl disulfide (metabolite of allicin), allyl-mercaptan (a metabolite of allicin and diallyl disulfide), allyl methyl sulfide (a metabolite of allicin and diallyl disulfide), allyl methyl sulfoxide (AMSO) (a metabolite of allicin and diallyl disulfide), and allyl methyl sulfone (AMSO[sub 2]) (a metabolite of allicin and diallyl disulfide). The highest amounts of diallyl disulfide metabolites have been noted after 48-72 hours. Maximal concentrations of the vinyldithiins, transformation products of allicin, occur 15-30 minutes after oral absorption.

Garlic organosulfur constituents and their metabolites are excreted primarily in urine and feces, and possibly via bile or intestinal mucosa. In human research, the elimination half-life of N-acetyl-S-allyl-L-cysteine is approximately six hours following ingestion of dried and fresh garlic. In laboratory research, garlic has been found to follow zero-order kinetics.

The applicable part of garlic is the bulb. The bulb of garlic contains the cysteine sulfoxide Many of the pharmacological effects of garlic are attributed to the allicin, ajoene, and other alliin, also known as S-allyl-L-cysteine sulfoxide. When the garlic bulb is crushed, ground, or cut, the alliin constituent is converted to allicin (also known as diallylthiosulfinate) by the enzyme alliinase . Fresh garlic contains approximately 1% alliin. One milligram of alliin is converted to 0.458 mg allicin. The amount of allicin in garlic preparations is dependent upon the method of preparation. Processes that involve maceration of the garlic clove increase the activity of alliinase. Freeze-dried garlic may contain little or no allicin. The age of garlic affects the amount of alliin contained in the product. Garlic is aged to reduce the content of other sulfur compounds and the odor commonly associated with garlic. The process to produce odorless aged garlic extract reduces the alliin content to only 3% of what is typically contained in fresh garlic).
 

Other garlic constituents include S-propylcysteinesulfoxide (PCSO) and S-methylcysteine-sulfoxide (MCSO), which can also be converted by alliinase to constituents such as allyl methane thiosulfinate, methyl methanethiosulfinate, and other thiosulfinates. Volatile constituents of garlic include diallyldisulfide (DADS), dimethyltrisulfide (DATS), and sulfur dioxide .
 

Garlic extracts have been shown to contain constituents such as E-ajoene. Aged garlic extracts may contain constituents such as S-allylcysteine (SAC) and S- allylmercaptocysteine (SAMC), while garlic oil may include constituents such as diallyldisulfide and dimethyltrisulfide. Heat and steam distillation used to produce garlic oil from crushed garlic converts allicin to allyl sulfides which are thought to have biological activity.
 

To improve effectiveness, garlic preparations may be enteric coated to protect the active constituents from degeneration by stomach acid 

Some evidence in humans suggests that garlic inhibits inflammatory compounds, including C-reactive protein (CRP) and inflammatory cytokines including interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha), and reduces levels of homocysteine . The anti-inflammatory effects of garlic might play a role in its potential clinical benefits related to diseases such as arthritis and cardiovascular disease. Researchers theorize that phytocompounds in garlic including allicin, allyl, cysteine, and allyl disulphide have antioxidant properties which protect against oxidative stress .

Fresh garlic has shown activity against Escherichia coli, methicillin-resistant Staphylococcus aureus, and Salmonella enteritidis; it has been suggested as a food additive to prevent food poisoning . In addition to fresh garlic, crude garlic extract has also been shown to have antimicrobial activity against Streptococcus mutans, suggesting it may be beneficial for eliminating bacterial in the mouth known to cause dental caries. Other in vitro research suggests that garlic extract may have antibacterial activity against several strains of mycobacteria, including Mycobacterium tuberculosis, Mycobacterium avium-intracellulare, and Mycobacterium kansasii, three bacteria associated with pulmonary infections . However, garlic extract does not seem to have additive effects when used in combination with antituberculosis drugs. Garlic oil has also been shown to have antimicrobial activity against Mycobacterium tuberculosis . The antibacterial activity of garlic oil has been attributed to its allyl sulfur compounds It has been suggested that garlic oil's antimicrobial activity is more potent than garlic powder on a unit weight basis.
 

The antimicrobial effects of garlic have been attributed to its allicin content. Allicin is believed to inhibit RNA synthesis and reduce DNA and protein synthesis. Allicin and other sulfur-containing constituents of garlic may also inhibit bacterial growth by interacting with and inactivating enzymes necessary for growth. The garlic constituent ajoene also possesses antibacterial activity against both Gram-positive and -negative bacterial species in vitro. The disulfide bond in ajoene may be responsible for these effects, but the exact mechanism of action is unclear.

Garlic seems to lower blood glucose in people with or without diabetes. Preliminary clinical research suggests some compounds in garlic, such as S-methylcysteine sulfoxide and S-allylcysteine sulfoxide, might have some antidiabetic activity. In vitro evidence suggests that S-allyl cysteine sulfoxide stimulate insulin secretion from beta-cells. Other in vitro evidence suggests that aged garlic extract can inhibit the formation of advanced glycation end products, which are associated with diabetic complication.

Various clinical studies have shown that garlic can improve levels of total cholesterol, low-density lipoprotein (LDL) cholesterol, oxidized LDL cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides. There is some evidence that various garlic constituents may be potent inhibitors of hepatic cholesterol synthesis. Garlic may also exert its antilipemic effect by stimulating the synthesis and secretion of apolipoproteins . In patients with hyperlipidemia, garlic might lower cholesterol levels by acting as a HMG-CoA reductase inhibitor (statin). Garlic may also reduce the activity of enzymes involved in cholesterol synthesis, including hepatic glucose-6-phosphate dehydrogenase, malic enzyme, and squalene monooxygenase, as well as enzymes that catalyze fatty acid synthesis such as fatty acid synthetase . However, some laboratory evidence suggests that garlic might also inhibit or reduce the activity of cholesterol 7 alpha-hydroxylase, an enzyme involved in the conversion of cholesterol to bile acids.

In various laboratory studies, garlic and its constituents displayed antioxidant activity, including increasing the activities of glutathione peroxidase, catalase, and superoxide dismutase; lowering xanthine oxidase activity; and inhibiting lipid peroxidation and prostaglandin production. Some laboratory evidence suggests that the antioxidant capacity of fresh garlic may be greater than that of dried garlic. In humans, evidence regarding the effect of garlic on serum antioxidant capacity or markers of oxidation is mixed. A meta-analysis of 12 randomized, controlled clinical trials shows that garlic increases the total antioxidant capacity of serum and the levels of superoxide dismutase, while decreasing serum malondialdehyde levels. However, there was considerable heterogeneity, with garlic doses varying from 80-4000 mg daily, and duration varying from 2-24 weeks. Subjects included those who were healthy and those with various different disease states.

Preliminary in vitro evidence suggests that garlic compounds, including ajoene, allicin, allyl methyl thiosulfinate, and methyl allyl thiosulfinate, might have activity against viruses such as cytomegalovirus, influenza B, herpes simplex virus type 1, herpes simplex virus type 2, parainfluenza virus type 3, vaccinia virus, vesicular stomatitis virus, and human rhinovirus type 2.

Human research shows that high-dose garlic powder for up to 4 years reduces arteriosclerotic and age-dependent plaque volume in both carotid and femoral arteries. For age-related vascular changes and atherosclerosis, garlic is thought to be beneficial and protect vascular endothelial cells from injury by reducing oxidative stress, inhibiting low-density lipoprotein (LDL) oxidation, and through antithrombotic effects. There is evidence that LDL oxidation may be inhibited by the organosulfur constituents of garlic, including S-allyl cysteine, S-allyl mercaptocysteine, alliin, allixin, N-acetyl-S-allyl cysteine, and diallyl disulfide (DADS). However, this hypothesis has been in dispute based on a six-month trial in moderately hypercholesterolemic volunteers, which failed to demonstrate any effects of garlic supplementation on lipoprotein oxidation. Also, garlic does not seem to reduce levels of lipoprotein (a), a lipoprotein similar to LDL, in human plasma.
 

In addition to inhibiting LDL oxidation, laboratory research suggests that garlic constituents, including diallyl sulfide (DAS) and diallyl trisulfide (DATS), suppress oxidized LDL-induced expression of E-selectin and vascular cell adhesion molecule (VCAM)-1, thereby decreasing monocyte adhesion to endothelial cells which occurs at early stages of atherosclerosis. Aged garlic extract does not appear to affect the expression of adhesion molecules nor the adherence of leukocytes on the surface of endothelium, although it does appear to reduce the development of fatty streak formation and cholesterol accumulation in the vessel wall of animals fed high cholesterol diets, suggesting an alternative method for protection against the onset of atherosclerosis. Similarly, in vitro and ex vivo evidence suggests that garlic powder extract may reduce lipid accumulation in atherosclerotic human aortic cells by inhibiting acyl-CoA:cholesterol acyltransferase activity and stimulating cholesteryl ester hydrolase. Some evidence in humans suggests that garlic inhibits inflammatory compounds, including C-reactive protein (CRP) and inflammatory cytokines. An increased level of these compounds is associated with an increased risk of cardiovascular disease.

In observational research, garlic supplementation increased calf blood flow in healthy individuals. The improvement was associated with and possibly mediated by increased plasma levels of interleukin-6 (IL-6). In this study, increased IL-6 was independent of the activation of the NO pathway. In human research, garlic reduced blood viscosity, which may help reduce the risk of cardiovascular disease and cerebral vascular accidents.

Garlic powder and aged garlic preparations have been shown to have antiplatelet properties in both patients with cardiovascular disease and in healthy volunteers. Garlic has been found to have antithrombotic properties and can increase fibrinolytic activity, decrease platelet aggregation and adhesion, increase the prothrombin time (PT), and inhibit metabolic enzymes in platelets responsible for the conversion of arachidonic acid into prostaglandins and other products. Raw garlic appears to dose-dependently inhibit platelet cyclooxygenase and reduce serum thromboxane B2. Antiplatelet activity may be attributable to garlic constituents, including adenosine, ajoene, allicin, and paraffinic polysulfides). Raw garlic seems to have more potent antiplatelet properties than cooked garlic . Crushing garlic before cooking might prevent some of the loss of antiplatelet activity . Garlic oil does not appear to affect platelet aggregation.

Garlic has been shown to treat warts and corns in human research; however, the mechanism is unclear but may be related to antiviral and enhanced immunologic effects. Garlic reportedly reduced cellular proliferation in viral effected cells and exerted anti-DNA activity. Garlic's fibrinolytic effect may cause the surrounding fibrin tissue around the corn capsule to lyse and separate from the tissue.

In vitro evidence suggests that garlic extract and commercial garlic tablets have antimicrobial activity against Helicobacter pylori, a common bacterial associated with stomach infections or peptic ulcer. The anti-Helicobacter pylori effects of garlic seem to be highest for the garlic constituent allicin, followed by undiluted garlic oil then garlic powder. The antibacterial effect of garlic products against H. pylori appears to be dependent on the content of allicin. For garlic constituents, antimicrobial activity appears to increase with the number of sulfur atoms contained in the constituent.
 

Early evidence suggests a possible protective effect of aged garlic on intestinal toxicity induced by methotrexate (MTX) and fluorouracil (5FU). Preliminary evidence suggests that garlic might interfere with the oral absorption of lead; the sulfur containing amino acids might chelate lead in the gastrointestinal tract. Samgyetang, a soup made from chicken, jujube, Panax ginseng, garlic, and chestnuts, appears to offer protection from experimentally induced peptic ulcers .

Evidence from animal research suggests that garlic oil 100-200 mg/kg every other day for 2 weeks enhances lymphocyte proliferation rate and increase the production of the cytokines interleukin 2 (IL-2), interferon gamma (IFN-gamma), IL-4, and IL-10 upon stimulation with concanavalin A. At low doses, garlic oil appears to enhance T cell response toward the Th1 type cytokines (e.g., IL-2 and INF-gamma). These cytokines have been associated with beneficial antitumor response. At high doses, garlic oil appears to enhance Th2-type cytokines (eg, IL-4 and IL-10) at high doses. Other animal research suggests that aqueous garlic solution 600 mg/kg/4 mL daily for one month decreases INF-gamma production and increases IL-4 production in phytohemagglutinin-activated rat spleen lymphocytes, suggesting that garlic may favor a humor immune response when administered at higher doses.
 

Some in vitro evidence suggests that garlic powder extract reduces lipopolysaccharide-induced production of IL-1beta and tumor necrosis factor (TNF)-alpha in human whole blood. Garlic powder extract also appears to reduce the activity of nuclear factor (NF)-kB, a transcription factor involved in inflammation associated with autoimmune diseases such as arthritis and inflammatory bowel disease, as well as atherosclerosis.
 

Garlic may also enhanced natural killer (NK) cell number and activity against tumor cell lines. However, while raw garlic juice, heated garlic juice, dehydrated garlic powder, and aged garlic extract all seem to increase NK cell activities in tumor-bearing mice, only aged garlic extract and heated garlic juice appear to inhibit the growth of tumor cells.
 

Garlic also appears to stimulate macrophage and lymphocyte proliferation, which may protect the body against immunity suppression induced by chemotherapy or radiation treatments. Animal research also suggests that long-term administration of garlic may improve age-associated decline in immune function. The garlic constituent alliin appears to increase the phagocytic function of peripheral blood leukocytes and monocytes 

Vasorelaxant properties of garlic have been noted in multiple preclinical studies. Cutaneous microcirculation has been shown to increase in humans following ingestion of 600 mg of garlic due to vasodilation of precapillary arterioles. In patients with hypertension, garlic is thought to reduce blood pressure by causing smooth muscle relaxation and vasodilation by activating production of endothelium-derived relaxation factor (EDRF, nitric oxide). It has been suggested that allicin is the component of garlic responsible for nitric oxide-mediated effects. Garlic may also attenuate age-related increases in aortic stiffness, which may improve vasoelasticity and protect against cardiovascular diseases .

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