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With the increasing costs of health care and the internet making access to information more readily available, patients using complementary therapy (CT) has increased in recent years. The National Center for Complimentary and Integrative Health (NIH) defines complementary therapy as the use of non-mainstream medicines or practices in conjunction with conventional western medicine practices (NIH, 2019). One such therapy is the use of garlic for reducing high blood pressure, lowering cholesterol and overall heart health. Garlic (Allium Sativum) has been used since ancient times in food and as a medicine. Many studies have been conducted on the various types of garlic and its effects.
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According to the Center for Disease Control (CDC) Heart disease is one of the leading causes of death in the United States and has different types (CDC, 2019). One of the most common types of heart disease is Coronary Artery Disease (CAD). CAD is caused by the buildup of plaque in the walls of the coronary arteries (CDC, 2019). This buildup causes the artery to become narrow or even completely blocked (CDC, 2019). This process is called atherosclerosis. Atherosclerosis can interrupt blood flow to the heart which can then lead to chest pain or angina, shortness of breath, myocardial infarction and death (CDC, 2019). CAD also causes the heart muscle to weaken which can lead to heart failure and arrythmias (CDC, 2019). Risk factors for CAD include hypertension (HTN), high cholesterol, sedentary lifestyle, unhealthy diet, obesity, and smoking (CDC, 2019).
The Joint National Commission (JNC) 8 guidelines (JNC 8 2017) defines HTN as “stage 1 hypertension (130-139/80-89 mm Hg); and stage 2 hypertension (≥140/≥90 mm Hg)” (Evidence Base section, para 2). Unmanaged HTN can lead to stroke and heart disease. HTN is managed in patients by medication and diet primarily. Garlic and its organosulfur compounds have been found to stimulate receptors that aid in vasorelaxation and inhibit platelet aggregation. According to (“Garlic”, 2019), “Garlic preparations were found to significantly reduce SBP by a mean of 9.1 mm Hg and DBP by a mean of 3.8 mm Hg compared to placebo…Such reductions in blood pressure seem comparable to those reported with currently used classes of blood pressure-lowering medications (average reduction, -9.1 mm Hg for SBP and -5.5 mm Hg for DBP)” (Hypertension section, para 2). A study by Ried K, Travica N, and Sali A. (2018) found:
Kyolic aged garlic extract has also been shown to be effective in reducing central hemodynamic measures including central blood pressure, pulse wave velocity, pulse pressure, and arterial stiffness, which are regarded as more important predictors than peripheral blood pressure for cardiovascular disease. (p. 2)
Garlic was also found to decrease serum cholesterol. In a previous study by Reid (2016) “garlic moderately but significantly lowers total serum cholesterol… if taken for >2 mo by patients with slightly elevated cholesterol” (p. 391S). By decreasing a patient’s cholesterol this also helps reduce risk factors in CAD.
Research trials for garlic have included garlic powder, aged garlic extract and raw garlic. Dosages have varied as well as delivery form, length of study and normotensive vs hypertensive control groups. Aged garlic extract showed the best results in most studies. According to (“Garlic”, 2019), daily doses of aged garlic extract of 1.2g – 2.4g reduces SBP & DBP. While doses of 2.4g – 7.2g/day resulted in short term reduction in platelet aggregation.
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Aged garlic extract can be purchased online and in most pharmacies. A 100ct bottle containing 300mg of aged garlic extract and 190mg of lecithin sells for approximately $12 at national pharmacy chains. The recommended dose is 2 capsules BID with meals.
The use of garlic as a CT does not come without some adverse effects. The most common are the lingering odor of breath and on the body when excreted in sweat. Gastrointestinal discomfort such as bloating, abdominal pain, and flatulence was also reported by subjects. Due to garlic’s ability to inhibit platelet aggregation the is potential to increase clotting time on patients who take blood thinners. Research also shows that garlic may interfere with some HIV drugs such as saquinavir (NIH, 2019).
Garlic is considered safe as a CT (NIH, 2019). Nursing management of a patient taking garlic supplements is fairly straightforward. The nurse should assess for any food or medication allergies. The nurse should ensure they get and accurate medical history and current medication list. Some patients do not inform providers of CT or over the counter (OTC) medications. The patient should be educated on the importance of disclosing all medication and CT including any OTC medication due to the possibility of drug interactions. A review of current medications to check for drug interactions should be performed prior to any patient starting a CT. The risk of increased clotting time and bleeding could occur if the CT is not reported. If this does occur the nurse should educate the patient on bleeding precautions such as soft bristled toothbrush, no razors, and to protect from injury.
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