## 2 Pomergnate Health-Promoting Properties
### Prevention of Cardiovascular Diseases  
The main risk factors for the occurrence of coronary diseases is dyslipidemia, characterized by an excessive increase in low-density lipoproteins (LDL) and/or low levels of high-density lipoproteins (HDL) [114; 115]. It is known that LDL oxidation contributes to atherosclerosis and the development of cardiovascular diseases [53; 116]. Inhibition of LDL oxidation is considered a promising way to avoid the storage of foaming cells and, ultimately, cholesterol deposits in the arteries. Due to its formidable antioxidant capacity, the extract obtained from the pomergnate skin has the power to suppress LDL oxidation and thus delay the advancement of atherosclerosis with an important decrease in foaming cell levels at the artery level. The polyphenols present in pomergnate, punicalagin (9), gallic acid (18) and, to a lesser extent, ellagic acid (8), increase the expression and secretion of the liver enzyme paraoxonase 1 in a dose-dependent manner, thus reducing the risk of developing atherosclerosis [117]. [PERSON] and [PERSON] in 2016 gave an insight into the anticoagulant, antiplatelet, and antianemic effects of _Punica granatum_ juice by studying the hematological profile of the rabbits used as an in vivo model. Their findings evidenced a substantial increase in erythrocyte count, mean corpuscular hemoglobin concentration after 30 days of treatment, whereas red cell distribution width was significantly reduced. Instead, leucocyte count, hematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and platelet count (PLT) were not modified at any dose. Furthermore, there was an important increase in bleeding time both after 30 and 60 days, and a significant rise in thrombin time (TT) and activated partial thromboplastin time (\(\alpha\)PTT) after 60 days, whereas prothrombin time did not change. Comparing the pomergnate ability in lowering cholesterol and the prolonged \(\alpha\)PTT time, they speculated that the cholesterol reduction induced by _P. granatum_ may lead to a decrease in the concentration of coagulation factors, influencing, in this way, \(\alpha\)PTT. In conclusion, data illustrated that _P. granatum_ significantly inhibited aggregation of platelets induced by adenosine diphosphate ADP and epinephrine (Epi) in the blood samples of animals treated already at 2 mL/kg for 30 and 60 days [118]. The hypothesis that pomergnate ameliorates the cardiac function has been also supported by [PERSON] et al. Indeed, they administered 220 mL of pomergnate juice to one hundred hospitalized patients suffering from unstable angina or myocardial infarction for 5 days in order, a the end, to evaluate cardiac markers and parameters. The results indicated a significant reduction in the intensity, occurrence, and duration of angina pectoris in patients with unstable angina. Moreover, the measurement of serum levels of troponin and malondialdehydedehyde revealed a decrease of these factors. Nevertheless, other parameters like interleukin-6,tumor necrosis factor alpha, blood pressure, and heart rate were not affected [119]. More recently, the possible interaction between ethanolic peel extract of _Punica granatum_ and doxorubicin (well known for its cardiotoxicity) was evaluated. The assessment was performed by measuring heart weight/body weight ratio, biochemical parameters, and histopathological changes. After the treatment with 100 mg/kg body weight, an increased heart weight/body weight ratio, in comparison with the doxorubicin-treated group, was observed as well as blood and tissue glutathione, superoxide dismutase, and catalase levels. On the contrary, creatine kinase, lactate dehydrogenase enzyme, and malondialdehydedehyde levels appeared significantly reduced. Concerning the histopathological morphology, the only assumption was that doxorubicin modified myocardium through vacuolar alterations in the heart muscle and necrosis of heart muscle with remote cells increasing in the size in between the necrotic and fragmented muscle fibers. Instead, treatment with _P.