This triple-blind controlled trial found that 250 mg daily aged black garlic (ABG) supplementation for 12 weeks produced complex changes in lipoprotein profiles among Grade I hypertensive adults. The supplement reduced total HDL particle counts while improving HDL particle quality—increasing phospholipid content and decreasing triglyceride percentage in large HDL particles. Simultaneously, ABG decreased cholesterol content in XXL-VLDL particles and provided greater benefits for participants with worse baseline metabolic profiles, including reduced total triglycerides and VLDL-lipid content. These findings add nuance to garlic's cardiovascular research landscape, which has historically focused on blood pressure rather than detailed lipoprotein remodeling. The paradoxical reduction in HDL particle number alongside improved HDL composition suggests ABG may enhance particle functionality rather than quantity—a potentially more meaningful cardiovascular marker. However, the clinical significance of these lipoprotein changes remains unclear without long-term cardiovascular outcome data. The modest sample size of 75 participants and 12-week duration limit broader applicability. As this is a preprint awaiting peer review, these intriguing but complex results require validation before recommending aged black garlic for cardiovascular health management in hypertensive populations.