DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20160096

To study the anti-hypertensive and lipid-lowering effects of garlic as add-on therapy to amlodipine in patients of hypertension with obesity

Vaishalee Punj, Rahat Kumar, Geeta Sharma, Ashok Khurana

Abstract


Background: To study the anti-hypertensive and lipid-lowering effect of aged garlic extract as add-on therapy to amlodipine in patients of hypertension with obesity.

Methods: A randomized, prospective, open-labelled study of 90 days duration was undertaken at department of pharmacology, SGRDIMSAR, Amritsar. Patients of hypertension with obesity attending out-patient department of Medicine, SGRDIMSAR, Amritsar and fulfilling the inclusion criteria were enrolled. Patients were allocated into two groups treated with either amlodipine alone or Aged Garlic Extract (capsule in dose of 250 mg twice daily) along with amlodipine. A total of 60 patients successfully completed the study.

Results: At the end of study period of 90 days, a highly significant (p<0.001) reduction was seen in systolic blood pressure (SBP) and diastolic blood pressure (DBP) in patients taking AGE along with amlodipine. On comparison with group taking amlodipine alone, difference of SBP was highly significant (p<0.001) in patients taking AGE along with amlodipine, but difference of DBP was not significant (p>0.05) between these two groups. There was a non-significant change (p>0.05) in lipid profile (serum total cholesterol, high-density lipoprotein cholesterol, triglycerides and low-density lipoprotein cholesterol) in patients taking only amlodipine but a significant reduction (p<0.05) in serum triglycerides, LDL and VLDL parameters of lipid profile in patients taking AGE along with amlodipine. Weight and BMI also reduced significantly (p<0.01) in patients taking AGE along with amlodipine.

Conclusions: AGE has been shown to have anti-hypertensive and lipid-lowering properties suggesting that garlic can be valuable agent in patients having hypertension with obesity.


Keywords


Aged garlic extract, Blood pressure, Lipid, Obesity, Amlodipine

Full Text:

PDF

References


James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J. Evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507-20.

WHO. A global brief on hypertension: silent killer, global public health crisis. World Health Day 2013. Report, 1-39. 2013. Geneva, Switzerland, World Health Organization. Available from: http://www.who.int/cardiovascular_diseases/publications/global_brief_hypertension/en/. Accessed at October 28, 2015

Anand MP. JNC7 Guidelines and Indian Scenario. In: Dr Pathak LA (editors). Postgraduate Medine 2004. API. 2004;18:139-44.

Theodore AK. Hypertensive Vascular Disease. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, editors. Harrison’s Principles of Internal Medicine. 18thed. New York: McGraw Hill. 2012:2042-59.

Shah S, Wander GS, Anand P, Maiya M, Mukherjee S, Munjal YP, Kamath SA. Hypertension in Special Situations. Indian Hypertension Guidelines-II. JAPI. 2013;61:28-32.

Mendall MA, Patel P, Ballam L, Strachan D, Northfield TC. C reactive protein and its relation to cardiovascular risk factors: a population based cross sectional study. BMJ. 1996;312(7038):1061-5.

Neal BL. Antihypertensive Agents. In: Katzung BG, Masters SB, Trevor AJ, editors. Basic & Clinical Pharmacology. 12th Ed. New Delhi: Tata McGraw-Hill. 2012:169-91.

Landsberg L, Aronne LJ, Beilin LJ, Burke V, Igel LI, Lloyd-Jones D. Obesity-Related Hypertension: Pathogenesis, Cardiovascular Risk, and Treatment. A Position Paper of the Obesity Society and the American Society of Hypertension. J ClinHypertens. 2013;15(1):14-33.

Ried K, Frank OR, Stocks NP. Aged garlic extract reduces blood pressure in hypertensives: a dose–response trial.Eur J ClinNutr. 2013;67:64-70.

Yeh YY, Liu L. Cholesterol-lowering effect of garlic extracts and organosulfur compounds: human and animal studies. J Nutr. 2001;131(3s):989S-93S.

Ide N, Nelson AB, Lau BHS. Aged garlic extract and its constituents inhibit Cu12-induced oxidative modification of low density lipoproteins. Plant Med. 1996;63:263-4.

Dennehy CE, Tsourounis C. Dietary supplements & herbal medications. In: Katzung BG, Masters SB, Trevor AJ, editors. Basic & Clinical Pharmacology. 12th Ed. New Delhi:Tata McGraw-Hill. 2012:1125-37.

Lasuna (capsule) [product information]. The Himalaya Drug Company, Bangalore, India; 2002. http://www.himalayawellness.com/products/pharmaceuticals/lasuna.htm. Accessed at June 15, 2015.

Flier SJ, Maratos-Flier E. Biology of Obesity. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, editors. Harrison’s Principles of Internal Medicine. 18thed. New York: McGraw Hill. 2012:2042-59.

Allain C. Enzymatic determination of total serum cholesterol. Clin Chem. 1974;20:470-5.

Trinder P. Triglycerides estimation by GPO-PAP method. Ann ClinBiochem. 1969;6:24-7.

Burstein M, Scholnic HR, Morfin R. Rapid method for the isolation of lipoproteins from human serum by precipitation with polyanions. J Lipid Res. 1970;11:538-95.

Warnick GR, Knopp RH, Fitzpatrick V, Branson L. Estimating Low-Density Lipoprotein Cholesterol by the Friedewald Equation Is Adequate for Classifying Patients on the Basis of Nationally Recommended Cutpoints. Clin Chem. 1990;36(1):15-9.

Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA. 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am CollCardiol. 2014;63(25):2985-3023.

Borek C. Antioxidant health effects of aged garlic extract. J Nutr. 2001;131(3):1010S-5S.

Benavides GA, Squadrito GL, Mills RW, Patel HD, Isbell TS, Patel RP, Darley-Usmar VM, Doeller JE, Kraus DW. Hydrogen sulfide mediates the vasoactivity of garlic. Proc Natl Acad Sci U S A. 2007;104(46):17977-82.

Rao PS, Satyanand V, Reddy CB, Mohan PR, Kumar MR, Narayanaswamy D. Effects of Garlic extract (Allium sativum) in combination with Amlodipine in mild to moderate essential hypertensive patients: An Open randomized parallel group study. JPRD. 2013;2(4):181-8.

Ried K, Frank OR, Stocks NP. Aged garlic extract lowers blood pressure in patients with treated but uncontrolled hypertension: A randomised controlled trial. Maturitas. 2010;67:144-50.

Steiner M, Khan AH, Holbert D, Lin RI. A double-blind crossover study in moderately hypercholesterolemic men that compared the effect of aged garlic extract and placebo administration on blood lipids. Am J ClinNutr. 1996;64(6):866-70.

Qidwai W and Ashfaq T. Role of Garlic Usage in Cardiovascular Disease Prevention: An Evidence-Based Approach. Evid Based Complement Alternat Med. 2013:Article ID 125649, 9 pages.

Seo DY, Lee SR, Kim HK, Baek YH, Kwak YS. Independent beneficial effects of aged garlic extract intake with regular exercise on cardiovascular risk in postmenopausal women. Nutr Res Pract. 2012;6(3):226-31.

Mathew BC, Biju RS. Neuroprotective effects of Garlic A Review. Libyan J Med. 2008;3(1):23-33.

Banerjee SK. Maulik SK. Effect of garlic on cardiovascular disorders: a review. Nutr J. 2002;1:4.

El-Beshbishy HA. Aqueous garlic extract attenuates hepatitis and oxidative stress induced by galactosamine/lipoploysaccharide in rats. Phytother Res. 2008;22(10):1372-9.

Kumar R, Chhatwal S, Arora S, Sharma S, Singh J, Singh N. Antihyperglycemic, antihyperlipidemic, anti-inflammatory and adenosine deaminase–lowering effects of garlic in patients with type 2 diabetes mellitus with obesity. Dovepress Journal: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 2013;6:49-56.

Shah FS, Shah GB. Single versus Combined Atorvastatin and Lasuna: Investigating Changes in Laboratory Parameters and Hydrogen Sulfide Post Treatment. Int J PharmTech Res. 2013;5(1):254-63.

Gardner CD, Lawson LD, Block E. Effect of raw garlic vs commercial garlic supplements on plasma lipid concentrations in adults with moderate hypercholesterolemia: a randomized clinical trial. Arch Intern Med. 2007;167(4):346-53.

Gómez-Arbeláez D, Lahera V, Oubiña P, Valero-Muñoz M, de Las Heras N, Rodríguez Y. Aged Garlic Extract Improves Adiponectin Levels in Subjects with Metabolic Syndrome: A Double-Blind, Placebo-Controlled, Randomized, Crossover Study. Mediators Inflamm. 2013: Article ID 285795, 6 pages.

Lee MS, Kim IH, Kim CT, Kim Y. Reduction of body weight by dietary garlic is associated with an increase in uncoupling protein mRNA expression and activation of AMP-activated protein kinase in diet-induced obese mice. J Nutr. 2011;141(11):1947-53.

Thomson M, Al-Amin ZM, Al-Qattan KK, Shaban LH, Ali M. Anti-diabetic and hypolipidaemic properties of garlic (Allium sativum) in streptozotocin-induced diabetic rats. Int J DiabMetab. 2007;15:108-15.