Nattokinase for Cardiovascular Disease
Nattokinase has only weak, surrogate-marker evidence for cardiovascular disease: it may modestly lower blood pressure, but it has never been shown to reduce heart attacks, strokes, or deaths, and the strongest long-term trial found no effect on artery health. It is not a substitute for proven therapies, and it carries a real bleeding risk.
Why this grade7-layer evidence engine
The grade is C (weak evidence) because every human trial measures surrogate risk factors rather than real cardiovascular events, and the results are small and inconsistent. The most rigorous and longest study, a 3-year RCT in 265 people (PMID 33843667), found a null effect on carotid artery thickening and stiffness. The only reliably positive signal is a modest blood-pressure drop of roughly 3.5 mmHg systolic, seen in a meta-analysis of six RCTs (PMID 39076715) and in smaller trials (PMID 18971533; PMID 27785095).
The evidence is further weakened by unfavorable lipid findings (the meta-analysis showed higher cholesterol at high doses) and by industry influence. The dramatic claim that nattokinase reverses carotid plaque rests on a single non-randomized study of 1,062 people (PMID 36072877) in which five authors worked for nattokinase manufacturers, a major conflict of interest that triggers an industry-funding warning on this entry.
Regulators and clinicians reinforce the caution. The US FDA has issued a warning letter treating clot-dissolving and plaque-clearing claims as unapproved drug claims, EFSA authorizes no cardiovascular health claim, and major medical bodies do not endorse nattokinase. Because cardiovascular patients often already take blood thinners, the documented bleeding risk makes self-treatment potentially harmful.
Scoring transparency
All scores computed by a 7-layer evidence engine — fully auditable▸View the full decision path (audit trail)
- compute_raw_score — 加權公式: L2×0.30 + L3×0.25 + L5×0.25 + L11×0.10 + L1×0.10 = 0.425
- tier_from_score — 依分數區間映射至 tier letter
- apply_hec_rules — 高品質 SR/MA 顯示 positive (1 篇 > 0 negative)
- tier_strict_requirement_check — Tier 條件達標，未降階
- detect_disputes — 偵測到 0 個 hard + 1 個 soft dispute
- decide_status — 依 tier + dispute 結果決定 status