ABSTRACT: Cardiovascular disease (CVD) is the leading cause of death in the world and our approach to the control and management of
CVD mortality is limited. Nattokinase (NK), the most active ingredient of natto, possesses a variety of favourable cardiovascular effects and the
consumption of Natto has been linked to a reduction in CVD mortality. Recent research has demonstrated that NK has potent fibrinolytic activity,
antihypertensive, anti-atherosclerotic, and lipid-lowering, antiplatelet, and neuroprotective effects. This review covers the major pharmacologic
effects of NK with a focus on its clinical relevance to CVD. It outlines the advantages of NK and the outstanding issues pertaining to NK
pharmacokinetics. Available evidence suggests that NK is a unique natural compound that possesses several key cardiovascular beneficial
effects for patients with CVD and is therefore an ideal drug candidate for the prevention and treatment of CVD. Nattokinase is a promising
alternative in the management of CVD.
Keywords: Nattokinase, natto, cardiovascular disease, antithrombotic agents, antihypertensive drugs, atherosclerosis

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