Nattokinase Supplementation and Cardiovascular Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 39076715 · doi:10.31083/j.rcm2408234
What was done
A systematic review and meta-analysis of randomized controlled trials was conducted using four electronic databases (registered on PROSPERO CRD42022315020). Two independent reviewers extracted data and performed bias risk assessments using Review Manager 5.4 software to evaluate the impact of nattokinase supplementation on cardiovascular risk factors compared to control interventions.
What was found
Six RCTs totaling 546 participants met inclusion criteria. Nattokinase supplementation significantly reduced systolic blood pressure (MD = -3.45, 95% CI: -4.37 to -2.18, p < 0.00001) and diastolic blood pressure (MD = -2.32, 95% CI: -2.72 to -1.92, p < 0.00001), while slightly increasing blood glucose (MD = 0.40, 95% CI: 0.20 to 0.60, p < 0.0001). For lipid parameters, low total dosage was associated with unfavorable shifts in total cholesterol (MD = 5.27, 95% CI: 3.74 to 6.81, p < 0.00001), HDL cholesterol (MD = -2.76, 95% CI: -3.88 to -1.64, p < 0.00001), and LDL cholesterol (MD = 6.49, 95% CI: 0.83 to 12.15, p = 0.02). High total dosage showed higher total cholesterol (MD = 3.18, 95% CI: 2.29 to 4.06, p < 0.00001) with no difference in HDL or LDL cholesterol. Triglycerides were unaffected (p = 0.71). No notable adverse events were reported.
Why it matters
This review indicates that nattokinase may serve as an adjunctive therapy for blood pressure reduction, but challenges assumptions that it provides broad lipid-lowering cardiovascular benefits.
Limits
The total sample size across the meta-analysis is small (546 participants across 6 studies). Measurement units for reported effect sizes are omitted from the abstract, and hard cardiovascular clinical endpoints were not assessed.
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