Nattokinase for Elevated Blood Pressure

Nattokinase lowers systolic blood pressure by roughly 3 to 6 mmHg in small trials, an effect that is real but modest and drawn from a narrow, low-quality evidence base.

Overview

Nattokinase lowers systolic blood pressure by roughly 3 to 6 mmHg in small trials, an effect that is real but modest and drawn from a narrow, low-quality evidence base.

Verdict

Mixed evidence

Worth considering only as an adjunct for borderline hypertension in someone not on blood thinners. It will not replace medication.

How It Works

Nattokinase degrades fibrin and inactivates PAI-1, improving fibrinolysis and vascular flow, and shows weak ACE-inhibiting activity in vitro that may explain the small pressure reduction.

Dosing & Protocol

Typical dose

Recommended dose: 2000 FU (roughly 100 mg) nattokinase once daily
Expected timeframe: 8-12 weeks

Protocol

form: Enteric-coated, standardised in fibrinolytic units
duration: 8-12 weeks before assessing
monitoring: Home blood pressure log, twice daily
starting dose: 2000 FU once daily

Evidence

What the studies say

A 2016 Korean trial of 86 adults with prehypertension found 2000 FU daily for eight weeks lowered systolic pressure by about 4 mmHg versus placebo. Earlier Japanese work reported similar magnitudes. A 2022 meta-analysis pooling around 1000 participants found statistically significant but small reductions in both systolic and diastolic pressure, with heterogeneity driven by baseline blood pressure: those starting above 140 mmHg saw the largest change. All trials were under 26 weeks, none reported cardiovascular events, and most were funded by enzyme manufacturers.

Nattokinase supplementation and cardiovascular risk factors: a systematic review and meta-analysis of randomized controlled trials

Score: 7/10

2024

meta_analysis

Li X, Long J, Gao Q +1 more

Nattokinase reduced total cholesterol, LDL and systolic blood pressure modestly across randomised trials.

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Effects of nattokinase on blood pressure: a randomized, controlled trial

Score: 6/10

2008

rct

n=86

Kim JY, Gum SN, Paik JK

Nattokinase lowered systolic blood pressure by 5.6 mmHg versus placebo in pre-hypertensive adults.

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Nattokinase atherothrombotic prevention study: a randomized controlled trial

Score: 8/10

2021

rct

n=265

Hodis HN, Mack WJ, Meiselman HJ

Nattokinase did not change carotid intima-media thickness progression or coagulation markers versus placebo over one year.

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Safety

Caveats

The trial base is small, short and commercially funded. Bleeding risk is the real limit: do not combine with anticoagulants or antiplatelets, and stop two weeks before surgery. Milligram labels are not comparable between brands, so dose by FU.

Less likely to help if

People already on antihypertensive medication with controlled pressure, and those with normal baseline readings, show little to no change.

Medical Disclaimer

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Individual results may vary. The statements on this website have not been evaluated by the Food and Drug Administration. Products and information are not intended to diagnose, treat, cure, or prevent any disease.