Can nattokinase affect Angiotensin-Converting Enzyme (ACE) levels?

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Last updated: February 23, 2025View editorial policy

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From the Research

Nattokinase can potentially affect Angiotensin-Converting Enzyme (ACE) levels in the body, as suggested by the most recent and highest quality study available 1.

Introduction to Nattokinase

Nattokinase is an enzyme derived from natto, a traditional Japanese fermented soybean food. It has been shown to have fibrinolytic (clot-dissolving) and anti-inflammatory properties. Some studies suggest that nattokinase may help lower blood pressure by reducing ACE activity.

Mechanism of Action

The mechanism by which nattokinase may affect ACE levels is not fully understood, but it's thought to involve its ability to break down fibrin, a protein involved in blood clotting. This fibrinolytic activity may indirectly influence ACE activity and blood pressure regulation, as seen in studies such as 2, which demonstrated the inhibition of ACE by subtilisin NAT (nattokinase) in natto.

Dosage and Administration

The typical recommended dose of nattokinase is 100-200 mg per day, taken orally. It's often available in supplement form as capsules or tablets. For best results, take it on an empty stomach, either 30 minutes before a meal or 2 hours after.

Safety and Efficacy

While nattokinase may affect ACE levels, it's essential to note that it should not be used as a replacement for prescribed ACE inhibitors or other blood pressure medications without consulting a healthcare provider. The effects of nattokinase on ACE are generally milder than pharmaceutical ACE inhibitors. A systematic review and meta-analysis of randomized controlled trials 1 found that nattokinase supplementation can be used as an effective adjunctive therapy for hypertension, but relatively low-dose supplementation of nattokinase may have no significant lipid-lowering effect.

Key Findings

  • 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) compared to placebo 1.
  • Nattokinase group with relatively high total dosage also had a higher total cholesterol (MD = 3.18,95% CI: 2.29 to 4.06, p < 0.00001) than control interventions, but no significant differences were found in levels of high-density lipoprotein cholesterol and low-density lipoprotein cholesterol 1.
  • No notable adverse events were reported in all studies due to intake of nattokinase.

Considerations for Use

If you're considering using nattokinase, especially if you have existing cardiovascular conditions or are taking blood thinners, it's crucial to discuss it with your doctor first to ensure it's safe and appropriate for your individual health situation. Additionally, more work is needed to determine whether the positive efficacy of nattokinase on cardiovascular risk factors is dose-dependent, as suggested by studies such as 3 and 1.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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