HEART HEALTH REPORT · Editorial

A Japanese Enzyme Clinically Studied for Plaque Reduction in Your Arteries

A 12-month clinical study of 1,062 adults reported a 36.6% average reduction in carotid artery plaque. Below is my breakdown of the research, the doses that worked, and what I look for when recommending it to patients.

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Dr. Marcus Whitfield, MD, FACC

Cardiology · 22 years in practice · Updated April 2026

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No. One

What the Clinical Studies Actually Measured

The Takayama study followed 29,000 adults in central Japan for sixteen years. Not a supplement trial. A dietary study. People who consumed the most natto died of cardiovascular disease 43% less often. Unfermented soy showed no effect. The enzyme was doing the work.

In 2017, Ren and colleagues documented a 36.6% reduction in carotid artery plaque over twenty-six weeks of nattokinase supplementation.

Then came Chen 2022. The largest nattokinase trial to date. 1,062 adults. Twelve months. Published in Frontiers in Cardiovascular Medicine.

The group taking roughly 10,800 FU per day showed measurable plaque reduction on ultrasound. Blood pressure improved. Triglycerides improved. LDL cholesterol improved.

The group taking roughly 3,600 FU per day saw none of those changes.

36.6%

Same compound. Same study. The only difference was the dose.

Chen et al., 2022 · 1,062 participants · 10,800 FU/day · Frontiers in Cardiovascular Medicine

No. Two

Why a 36.6% Reduction Changes the Whole Picture

In cardiovascular research, every 1% reduction in arterial plaque is associated with roughly 25% lower risk of a cardiovascular event. The higher-dose group averaged 36.6%. That number does not just change a scan. It changes the conditions that drive multiple risk factors at once.

Blood pressure

Patients in the high-dose group saw 5 to 10 mmHg lower systolic readings.

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Cholesterol

They also saw that LDL dropped by 18% and HDL rose by 15%.

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Triglycerides

Down 15% over twelve months.

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Event risk

Every 1% plaque reduction is linked to roughly 25% fewer cardiac events.

No. Three

It Does Something Heart Medication Was Never Built to Do

Most of my patients are already doing something for their heart. A statin. A blood pressure pill. Aspirin. Diet changes. Walking. These are good steps. Each one targets one piece of the picture.

A statin

lowers cholesterol.

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Aspirin

stops platelets from clumping, preventing new clots.

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A BP pill

reduces pressure inside the arteries.

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Diet & exercise

improve the numbers from the lifestyle side.

None of them break down fibrin.

Fibrin is the tough protein mesh that builds up inside artery walls over a lifetime. Aspirin stops new clots from forming. It does not clear what is already there. A statin lowers cholesterol production. It does not address the structural buildup that has been layering on for decades.

Nattokinase is one of the very few natural compounds clinically studied to support the body’s own ability to break down that existing buildup. It fills a gap none of those other steps were designed to fill. That is why I stopped thinking of it as a competitor to what my patients are already doing and started thinking of it as the missing piece.

No. Four

Most Nattokinase Never Reaches Your Bloodstream

Nattokinase is a protein. Stomach acid breaks down proteins. A standard capsule dissolves in the stomach within minutes. The enzyme gets destroyed before it reaches the small intestine, where absorption actually happens.

Enteric coating is a pH-sensitive barrier that stays intact in stomach acid and dissolves only in the intestines. The enzyme arrives whole. Most nattokinase products do not use it. If the label does not say enteric-coated, assume it is a standard capsule.

No. Five

The Formula I Could Not Find on a Shelf — So I Started Recommending This One

For years, I wrote down an ingredient list and told patients to assemble it themselves. The enzyme, the co-factors, the right capsule type. Most of them never did. Nobody wants to take seven capsules from seven bottles every morning.

The product I now point patients toward is called Evera.

10,000 FU of nattokinase per serving with enteric coating. Aligned with the dose range that produced the headline results in the Chen 2022 trial. The lower-dose arm saw nothing. Evera is built on the dose that worked.

Paired with CoQ10 for heart muscle energy. Bromelain, turmeric, and ginger for a healthy inflammatory response. Olive leaf for vascular support. White willow bark for healthy circulation.

Nattokinase 10,000 FU

Aligned with clinical-study dose range

CoQ10

Cellular energy in heart muscle

Bromelain

Circulatory support

Turmeric

Inflammation support

Ginger

Inflammation support

Olive Leaf

Vascular support

White Willow Bark

Traditional cardiovascular co-factor

One daily serving

No bottle pile-up. No guesswork.

Every ingredient on the label with its exact dose. Third-party tested. No proprietary blends. Enteric-coated capsules designed to deliver the enzyme past stomach acid intact.

No. Six

What Patients Are Telling Me

“I tried nattokinase two years ago from Arthur Andrew. Took it for three months and felt absolutely nothing. I wrote it off. When I saw the dose difference I figured I’d try one more time. About six weeks in, I realized my legs didn’t feel as heavy on my evening walks and I wasn’t getting that same sluggish feeling after dinner. I was not expecting that.”

Benjamin R., 68 · Previously tried Arthur Andrew Nattovena · On Evera Heart 4 months

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“The first thing I noticed was the stairs at work. I used to pause at the top of the second flight and pretend I was checking my phone. Around week five, I got to my desk and realized I hadn’t stopped. My wife noticed before I did. It’s not dramatic. It’s just that the thing that used to stop me doesn’t stop me anymore.”

Mark D., 49 · On Evera Heart 5 months

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“My doctor ran my labs at my eight-month checkup. My triglycerides were down from 182 to 139, and my blood pressure reading that morning was 124/78 instead of the 140s over high 80s I’d been seeing at home. He asked me what I changed. I showed him the bag.”

Jessica K., 55 · On Evera Heart 8 months

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Important Safety Note

Nattokinase supports the body’s natural fibrinolytic activity. If you currently take a blood thinner, please speak with your doctor before starting. Discontinue use two weeks before any scheduled surgery. We put this notice in larger type than most companies because we would rather lose a sale than have a customer harm themselves.

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References

Chen H, et al. (2022). Effective management of atherosclerosis progress and hyperlipidemia with nattokinase: A clinical study with 1,062 participants. Frontiers in Cardiovascular Medicine, 9, 964977.
Ren NN, et al. (2017). A clinical study on the effect of nattokinase on carotid artery atherosclerosis and hyperlipidaemia. Zhonghua Yi Xue Za Zhi, 97(26), 2038-2042.
Nagata C, et al. (2017). Dietary soy and natto intake and cardiovascular disease mortality in Japanese adults: The Takayama study. American Journal of Clinical Nutrition, 105(2), 426-431.
Sumi H, et al. (1990). Enhancement of the Fibrinolytic Activity in Plasma by Oral
Administration of Nattokinase. Acta Haematologica, 84(3), 139-143.

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Heart Health Report, Honestly Made

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Consult your healthcare provider before starting any new supplement, especially if you take prescription medications or have a medical condition. Individual results may vary.