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monitored by a questionnaire at week four, eight, and 12 appointments. Compliance was also monitored by calendar entries. Results A significant reduction in systolic blood pressure from baseline in the group taking two garlic tablets per day compared with the placebo group over the 12 weeks was found, although no change in diastolic blood pressure was noted. When analysis adjusted for five participants with poor compliance or a change in medication regimen, a significant difference in systolic blood pressure was still found, but at both eight and 12 weeks. Systolic blood pressure in group four was significant at eight weeks when compared to the placebo group. Group one systolic blood pressure dropped at 12 weeks, but was not significant when compared to the placebo group. Treatment with the garlic capsules did not affect all participants; covariate analysis by gender, age, BMI, smoking status, and number of antihypertensive medications was completed, but did not explain results. Diastolic blood pressure reduction was largest in group two, although was insignificant when compared to the placebo group. During the study, four participants changed their medication regime and five patients withdrew after four weeks. Three withdrawals were due to gastrointestinal complaints, one due to a broken arm, and one who no longer wished to participate. Participants in the garlic groups reported minor complaints in the first week including constipation, bloating, flatulence, reflux, garlic taste, difficulty swallowing capsules, dry mouth/cough. Most participants found taking the garlic capsules easy and acceptable, especially those taking fewer capsules per day. Participants reported willingness to continue taking garlic capsules after trial if effective, as well as pay the out-of-pocket cost of $0.30 per capsule. Blinding success of the study was measured by a questionnaire in which one third of participants guessed their treatment group correctly. Discussion This study showed that aged garlic extract has the potential to lower systolic blood pressure in patients with uncontrolled hypertension. A daily dose of two capsules (480mg) of aged garlic extract significantly lowered systolic blood pressure by -11.8 + 5.4mm Hg compared with a placebo group over 12 weeks. The daily dose of four capsules also lowered systolic blood pressure, but mean difference was -7.4 + 4.1 mm Hg at eight weeks when compared to the placebo group and was therefore only borderline significant. This difference when comparing group four and group two could be due to poorer compliance and lesser tolerability in group four. The gastrointestinal complaints that caused three participants to drop out could have been because genetics factors that can cause lower tolerance of sulphur-containing foods, inflammatory status, and/or levels of molybdenum and vitamin b12. The study had limited power due to a response rate of only 14% even before withdrawal was accounted for. Future recommendations include testing aged garlic extract as an alternative antihypertensive medication in other age groups, exploring underlying factors (genetic variations), completing the study with a larger sample size to compare the effect of taking both the garlic capsules and prescribed antihypertensive medications, as well as a longer study to investigate the prolonged effect of aged garlic extract on cardiovascular morbidity and mortality.
Works Cited Ried K, Frank OR, Stocks NP. Aged garlic extract reduces blood pressure in hypertensives: A dose-response trial. European Journal of Clinical Nutrition. 2013;67:64-70.