## 3 Results  
### Analysis of Efficacy  
A total of 69 volunteers were assessed for eligibility, and 40 individuals (Men: 23; Women: 17) were enrolled and successfully completed the study according to its design (Figure 2). At baseline, the groups were cross-matched in regards to age and the main anthropometric and hemodynamic parameters (Table 2). Figure 2: CONSORT (Consolidated Standards of Reporting Trials) flow diagram. The most recently released International Guidelines suggest to firstly manage normal-high BP values and stage I hypertension by increasing weekly aerobic physical activity and reducing the overall energy intake with the ultimate aim to maintain the BMI between 20 and 25 kg/m\({}^{2}\) (or keeping the waist size to less than 94 cm for men and 80 cm for women) [5]. Other recommendations from ESH include the urgency to reduce the daily intake of alcohol, salt (<5 gr/day), and processed meat, by increasing the intake of vegetables, olive oil, and low-fat dairy products, and refraining from passive and active cigarette smoking [5]. Even though the aforementioned lifestyle measures are undoubtedly effective, they are not always sufficient to manage BP levels, even in low-risk individuals. For this reason, during the last years, pre-clinical and clinical investigators have been searching for natural compounds with a detectable BP lowering effect in humans [21]. Therefore, a constantly growing body of evidence supports the use of a number of nutraceuticals in reducing BP, with some specificities relating to different mechanisms of action and pleiotropic effects [21]. Previous studies on black garlic indicated a food with higher levels of reducing sugars, organic acids, and bioactive compounds (particularly S-allyl-cysteine and coumaric acid) than fresh garlic [22]. In effect, the consumption of aged black garlic has been recently associated to clinically detectable improvements in a number of CV risk factors, as long as the extent of these effects has been shown to be dependent on the garlic aging process and the amount and type of accumulated chemical compounds [23]. Recently, a randomized double blind crossover clinical study involving a sample of 67 hypercholesterolic individuals showed that the consumption of 250 mg aged black garlic extract with 1.25 mg S-allyl-L-cysteine was able to significantly decrease DBP after 6 weeks of daily dietary supplementation [8]. As suggested by the authors, the mechanisms of action by which aged black garlic could modulate BP involve antioxidant activity by organosulfur compounds, the regulation of transcription factors involved in hypertension, and ACE regulation [24]. In this context, animal studies had already shown that black garlic extracts and their bioactive compounds have a greater inhibitory effect on endothelial ACE activity than normal garlic extracts (88.8% versus 52.7%) [25]. In the latest years, pomeranate has also gained widespread popularity as a functional food and nutraceutical source, and its consumption has been studied in relation to a variety of chronic diseases including CV diseases [26]. A systematic review and meta-analysis of randomized clinical studies suggested consistent benefits of pomeranate juice consumption on both SBP and DBP, with an effect on SBP that was independent from the duration of dietary supplementation [9]. Moreover, pomergnanate juice was shown to significantly reduce intensity, occurrence, and duration of angina pectoris in patients with unstable angina [27]. In our study, combined dietary supplementation with aged black garlic and pomergnanate extracts was associated with significant improvements in SBP and DBP.