Can You Actually Reverse Arterial Plaque? A Closer Look at the Study Behind the Headlines

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Tuesday, April 14th 2026 at 12:15 pm

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GMI Reporter

David Sinclair just revealed one of the biggest studies on nattokinase.

A comprehensive Chinese study of 1,067 people found that nattokinase reversed cardiovascular disease by removing up to 95% of arterial plaque in one year.

This supplement is an enzyme from fermented… https://t.co/0Y48hPnf3M pic.twitter.com/HILGmaUsT2

-- John Cumbers (@johncumbers) April 12, 2026

Nattokinase has been getting a lot of attention lately, and a big part of that traces back to a conversation between David Sinclair -- a Harvard-trained geneticist known for his work on aging biology -- and Peter Diamandis, founder of the XPRIZE Foundation and a prominent voice in exponential health technologies. Like most things that go viral, the nuance got left behind -- and what stuck was a single compelling idea: that arterial plaque might not be as permanent as we've been led to believe.

But the study they were referencing, published in Frontiers in Cardiovascular Medicine, tells a more nuanced story than the headlines suggest. Researchers followed 1,062 people over 12 months, tracking both blood lipid levels and physical changes in the carotid arteries via ultrasound. What makes this study worth paying attention to isn't just its size -- it's that it measured both the biochemistry and the actual anatomy, before and after participants took nattokinase consistently.

The daily dose was 10,800 fibrinolytic units (FU), which is significantly higher than what you'll find in most off-the-shelf supplements. Researchers looked at triglycerides, total cholesterol, LDL, HDL, carotid artery wall thickness (CCA-IMT), and plaque size. Taken together, the numbers paint a picture of meaningful, multi-front improvement in cardiovascular risk markers.

What happened with blood lipids

Across the group, the changes were pretty remarkable:

• Total cholesterol dropped about 15.9%
• Triglycerides fell roughly 15.7%
• LDL came down around 18.1%
• HDL went up about 15.8%

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These weren't isolated wins in a handful of participants, either. More than 80% of the group improved across most lipid markers, and for total cholesterol specifically, that number topped 95%.

What happened in the arteries themselves

Using Doppler ultrasound, the researchers saw measurable structural changes -- not just better blood work, but thinner artery walls and smaller plaques.

On average, carotid wall thickness dropped from 1.33 mm to 1.04 mm, a reduction of about 21.7%. Plaque size shrank by roughly 36%. About 78% of participants saw improvement in arterial thickness, and two-thirds saw their plaque burden decrease.

That said, this wasn't a clean sweep. There was real variability from person to person. The pattern points more toward regression and stabilization than across-the-board plaque elimination.

Dose matters -- a lot

One of the most important details in this study is easy to miss. A subset of participants taking 3,600 FU per day -- which is much closer to what most commercial nattokinase products contain -- didn't see statistically significant improvements in either lipid levels or arterial measurements. The contrast with the high-dose group is hard to ignore, and it may explain why past studies using lower doses have come back with mixed results. There seems to be a threshold you need to cross before things start to shift.

How does nattokinase actually work?

Most people know nattokinase as a fibrinolytic enzyme -- it breaks down fibrin and plays a role in how the body handles clots. But the data from this study hints at something broader. The researchers describe a cluster of overlapping effects: clot modulation, lipid reduction, antioxidant activity, and influence on LDL oxidation and endothelial function.

That kind of multi-pathway activity isn't unusual for compounds that come from fermentation. Fermented foods tend to produce a web of biological effects rather than acting through one clean mechanism, and nattokinase fits that mold.

Speaking of which -- while nattokinase is most closely associated with natto (the Japanese fermented soybean dish), similar enzymatic activity can come from fermenting other substrates, including chickpeas, using Bacillus subtilis. It's less a magic bullet and more a window into how fermentation creates biologically active compounds with wide-reaching effects.

For anyone who wants to dig deeper, the GreenMedInfo nattokinase database pulls together dozens of studies on its role in blood pressure, endothelial health, thrombosis, and lipid metabolism.

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References

1. Chen H, et al. Effective management of atherosclerosis progress and hyperlipidemia with nattokinase: A clinical study with 1,062 participants. Frontiers in Cardiovascular Medicine (2022). 

2. Jensen GS, et al. Consumption of nattokinase is associated with reduced blood pressure. Integrative Blood Pressure Control (2016).

3. Wu H, et al. Nattokinase promotes neurovascular recovery and neurogenesis post-stroke. Journal of Agricultural and Food Chemistry (2023).

4. Chiu H-W, et al. Nattokinase attenuates endothelial inflammation via SRF and THBS1 pathways. International Journal of Biological Macromolecules (2024).

5. Cesarone MR, et al. Prevention of venous thrombosis during long-haul flights with nattokinase. Angiology (2003).