Abstract

Introduction

Cardiovascular Diseases (CVDs) continue to be the leading cause of death globally, which highlights the need to evaluate nutraceuticals like Aged Garlic Extract (AGE) for risk factor management. This systematic review and meta-analysis compiles the data on how AGE affects blood pressure, lipid profiles, inflammation, and glycaemic control in adults at risk for CVD.

Methods

PRISMA guidelines were followed when searching databases (PubMed, Cochrane CENTRAL, Google Scholar) for randomized, double-blind, placebo-controlled trials from the beginning to May 2025. Research that was observational or crossover was not accepted. Standardised Mean Differences (SMDs) with 95% Confidence Intervals (CIs) were calculated using random-effects models, and the risk of bias was assessed using Cochrane tools.

Results

Systolic (-1.71 mmHg, p = 0.54) and diastolic (-0.77 mmHg, p = 0.44) blood pressure decreased non-significantly in ten trials (n = 625), with dose-dependent trends (e.g., -1.25 mmHg SBP at ≤ 1200 mg/day). Triglycerides trended lower (-22.08 mg/dL, p = 0.24), and TNF-α dropped significantly (-178.62 fg/mL, p = 0.02). Heterogeneity was low-moderate for lipids/inflammation (I2 = 0-64.65%) but high for blood pressure (I2 = 87.39%).

Discussion

AGE marginally decreases cardiovascular risk factors, particularly inflammation (TNF-α), but has variable, dose-dependent effects upon blood pressure and cholesterol. Inconsistent doses and heterogeneity of the studies prevent definitive conclusions; future studies should use a standardised protocol.

Conclusion

There are dose-dependent cardiovascular benefits to supplementation with AGE, including reductions in TNF-α and possibly blood pressure and cholesterol. Larger, standardised studies are required to optimize the dosage for high-risk populations. Registered in PROSPERO (CRD420251033175).

Keywords: Aged garlic extract, Cardiovascular diseases, Blood pressure, Lipid profile, Inflammatory markers, Randomized controlled trials.
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