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The direct endothelium protection (4, 8, 31), could partly explain its mentioned influence on the NO-system (8), with a counteracted overexpression of endothelin (38), (note, endothelin has potent ulcerogenic and vasoconstrictor actions in the stomach (67), counteraction of the effects of NOS-inhibitors and NO-precursor (8, 10, 12, 25, 34-40), effects which are seen in particular with external fistula healing (10, 12)

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[75] reported that black garlic positively modulates various cardiovascular risk factors, including blood pressure and cholesterol levels

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doi: 10.3389/FCIMB.2018.00011 72 VangTCongiaMMacisMDMusumeciLOrrVZavattariPet al

8 Notably, in patients with obesity and HFpEF, these dedicated HFpEF trials showed a significant improvement in patient-reported outcomes measured by the KCCQ-CSS