Ask Dr. Casey: Garlic and Cardiovascular Health.
Hi Dr. Casey,
I have a family history of cardiovascular disease, and I have high cholesterol myself. I have tried red yeast rice with mild improvements in cholesterol numbers, but am wondering if there is something else I can do to help support my heart and vascular health?
- Jeremy S
Hi Jeremy,
I <3 this question! It sounds like you have already done some research on natural therapeutics for cardiovascular health. Some statin pharmaceuticals are actually based on the active constituent of red yeast rice - monacolin k. I have seen a direct clinical correlation with the type of red yeast rice product/brand used in its effectiveness for reducing LDL, which is considered to be the more vessel-damaging form of cholesterol. Unfortunately, this is because of the unregulated nature of much of the supplement industry. Using companies that do third party testing is important, as well as looking at Consumer Lab reports to see products that do not contain what they claim. So as a first step, you may want to see if there is a more effective brand of red yeast rice to gain maximal efficacy out of this intervention. I would encourage you to dose CoQ10 alongside any statin or red yeast rice as well. In addition to being an important antioxidant that supports cardiac mitochondria, CoQ10 also mitigates the muscle soreness and fatigue many may experience if on statin therapy.
I do believe food is the medicine we take three times a day whether we think of our meals in that light or not. There are scores of supplements and foods I could focus on for this article, but I’d like to focus on one that gets an underrated wrap: good ol’ garlic. Despite what it may do to someone’s breath, that’s the only way in which garlic stinks!
A medicinal compound of garlic, allinin, is present in raw, unprocessed forms of garlic. Allinin is converted to the more metabolically active component, allicin, upon processing (crushing, cutting, blending, etc). Allicin is responsible for many of the health boosting properties that garlic is known for, including antiviral, antimicrobial and cardioprotective mechanisms. The activity of allicin peaks about 10-20 minutes after a clove of raw garlic is processed. So that big jar of pre-minced garlic is not the most medicinally potent food you could be consuming.
There are countless studies now backing garlic as a superfood that improves cardiovascular outcomes. A comprehensive 2024 review article found that garlic consistently lowered LDL, increased HDL (1) and has been shown to prevent plaque formation through preventing oxidation of LDL (2). Oxidation of LDL is why it is considered a greater potential for cardiovascular risk, as plaques can restrict blood flow and damage blood vessels, leading to more cardiac events and undesired outcomes like stroke, heart attack and high blood pressure. Through more in depth laboratory analysis, there is potential for deeper understanding of markers that measure this risk beyond LDL alone.
Now, how to incorporate the glories of garlic into everyday life? It is considered a cardiovascular tonic, afterall. We can turn to real life examples of cardiovascular fitness from other cultures that have stood the test of time over millennia. In Mediterranean cultures, garlic is a cornerstone of cooking. Especially in Spanish and Italian cuisine, a base of just about any cooked dish begins with sofrito: onion, garlic, carrot, celery (or similar variation) slow cooked in olive oil. Not only can this preparation enhance the taste of the dish by setting a delish base for the rest of the meal to be cooked on, it is full of antioxidant nutrients - garlic included. A 2019 study demonstrated a decrease in cardiovascular markers and increase in bioavailability of cardioprotective compounds when eaten once daily (3). The Italians just get food right on all levels - both taste and health benefits!
In Asian culture, a traditional preparation is fermented garlic, also known as black garlic. Before you turn your nose up at the thought of fermented garlic, its taste will surprise you. Through the aging process, the garlic actually turns sweet, almost balsamic-like, and its taste resembles nothing like the garlic you have known. A 2023 review study demonstrated a 12-week trial of black garlic as a successful intervention in decreasing LDL and total cholesterol,, increasing HDL and decreasing blood pressure (4).
In short, Jeremy, get your daily dose of garlic in! Pharmaceutical companies are actually doing trials of what constituents they can isolate from garlic to make into medication. The supplement industry offers aged garlic extract as an additional way to get this potential form of medicine in. I hope that garlic will keep cardiovascular disease and vampires at bay, but not a romantic partner!
Medical Disclaimer
Information in this article is meant for informational purposes only and is not intended as medical advice. Discuss with your own health care provider before taking medication or nutritional, herbal or other supplement for a health problem.
Citations
1. Du, Y., Zhou, H. & Zha, W. Garlic consumption can reduce the risk of dyslipidemia: a meta-analysis of randomized controlled trials. J Health Popul Nutr 43, 113 (2024). https://doi.org/10.1186/s41043-024-00608-1
2. Gao T, Gao S, Wang H, Wang S, Li L, Hu J, Yan S, Zhang R, Zhou Y and Dong H (2024) Garlic ameliorates atherosclerosis by regulating ferroptosis pathway: an integrated strategy of network pharmacology, bioinformatic and experimental verification. Front. Pharmacol. 15:1388540. doi: 10.3389/fphar.2024.1388540
2. Hurtado-Barroso S, Martínez-Huélamo M, Rinaldi de Alvarenga JF, et al. Acute Effect of a Single Dose of Tomato Sofrito on Plasmatic Inflammatory Biomarkers in Healthy Men. Nutrients. 2019;11(4):851. Published 2019 Apr 15. doi:10.3390/nu11040851
3. Nirvanashetty S. High Potency Aged Garlic Extract Reduces Cardiovascular Disease Risk Factors in Healthy Participants: A Randomized, Double-Blind, Placebo Controlled Study. Journal of Complementary and Alternative Medicine. 2023 September 20, 2023;6(1)
