When people think about heart-healthy supplements, the usual names come up: fish oil, CoQ10, magnesium. These have been discussed for years and have varying degrees of clinical support behind them. But in recent conversations with cardiologists and cardiovascular researchers, one ingredient keeps surfacing that most consumers have never heard of: aged garlic extract.

What Is Aged Garlic Extract?

Aged garlic extract, often abbreviated as AGE, is produced by slicing raw garlic and aging it in a controlled environment for up to 20 months. The aging process transforms the harsh, unstable compounds found in raw garlic — particularly allicin — into more stable, bioavailable compounds like S-allyl cysteine and S-allyl mercaptocysteine.

These compounds are what distinguish aged garlic extract from the garlic you cook with or the garlic supplements you find in most pharmacy aisles. The aging process is what gives AGE its unique pharmacological profile.

What the Research Shows

The clinical evidence behind aged garlic extract is more robust than most consumers realize. A randomized, double-blind, placebo-controlled trial published in the Journal of Nutrition in 2016 found that participants who took aged garlic extract daily for 12 months showed a significant reduction in low-attenuation plaque — the type of arterial plaque most associated with heart attack risk — compared to the placebo group.

A 2020 meta-analysis published in Experimental and Therapeutic Medicine pooled data from 12 clinical trials and concluded that aged garlic extract significantly reduced both systolic and diastolic blood pressure in hypertensive patients. The magnitude of the reduction — approximately 8 to 10 mmHg systolic — was comparable to some first-line blood pressure medications.

More recently, a 2024 study published in Circulation Research found that AGE supplementation was associated with improvements in endothelial function — the ability of blood vessels to dilate and contract properly — in adults with early-stage cardiovascular disease.

Why Cardiologists Are Paying Attention

The reason aged garlic extract has gained traction among cardiologists is not just the individual study results. It is the consistency of the findings across multiple endpoints: blood pressure, arterial plaque, cholesterol ratios, endothelial function, and oxidative stress markers. Few supplements have shown positive results across that many cardiovascular parameters in controlled studies.

Dr. Matthew Budoff, a cardiologist and professor at the Lundquist Institute at Harbor-UCLA Medical Center, has led several of the key clinical trials on aged garlic extract. His research group has published data showing that AGE can slow the progression of coronary artery calcification — a marker of atherosclerotic disease — in both observational and interventional studies.

Important Caveats

No supplement replaces the foundational strategies for cardiovascular health: regular physical activity, a diet rich in whole foods, blood pressure management, cholesterol management, and not smoking. Cardiologists are clear on this point.

Aged garlic extract should be viewed as a potential complement to — not a substitute for — evidence-based medical care. It also carries some interaction risks. Because AGE has mild blood-thinning properties, patients taking anticoagulant medications like warfarin should consult their physician before starting supplementation.

Dosing matters as well. The clinical trials that produced positive results typically used standardized doses in the range of 600 to 2,400 milligrams per day. Over-the-counter products vary significantly in their formulation and concentration, so consumers should look for products that specify the amount of S-allyl cysteine per dose and carry third-party testing certifications.

The Takeaway

Aged garlic extract is not a miracle cure for heart disease. But it is one of a small number of dietary supplements with a meaningful and growing body of clinical evidence behind it. For patients already managing their cardiovascular risk through lifestyle and medication, it may represent a low-risk addition worth discussing with their cardiologist.