Hypertensive crisis associated with high dose soy isoflavone supplementation in a post-menopausal woman: a case report [ISRCTN98074661].

BACKGROUND: Isoflavones are gaining popularity as alternatives to hormone replacement therapy. However, few guidelines exist to inform the public as to an appropriate dose. This case involves a postmenopausal woman who experienced a hypertensive crisis while consuming a high-dose isoflavone supplement as part of a research protocol. CASE PRESENTATION: The participant was part of a placebo-controlled crossover trial to investigate the potential synergism of the antioxidant activity of soy isoflavones and vitamin C. Upon entry into the study, this healthy, well-nourished, normotensive postmenopausal woman (51 years old), consumed the first of four randomly assigned treatments (500 mg vitamin C plus 5 mg/kg body weight soy isoflavones). During this treatment, the participant's systolic blood pressure spiked to a recorded 226/117 mmHg, necessitating medical intervention and discontinuation of study participation. Two plausible mechanisms for this hypertensive crisis are discussed. CONCLUSION: Due to the availability and increasing popularity of soy supplements, practitioners should be aware of the potential side effects associated with their use. Practitioners counseling clients who are consuming soy isoflavone supplements should advise them that elevated blood pressure may be a potential side-effect to consider and monitor.

Soy isoflavone and ascorbic acid supplementation alone or in combination minimally affect plasma lipid peroxides in healthy postmenopausal women.

The objective of this study was to assess synergistic antioxidant properties of vitamin C and isoflavones. The design was a placebo-controlled crossover trial: 500 mg vitamin C, 5 mg/kg body weight isoflavones, 500 mg vitamin C plus 5 mg/kg body weight isoflavones, or placebo. Total lipid peroxides, plasma vitamin C, and blood pressure were measured. Eight of 10 healthy postmenopausal women completed the study. A multiple analysis of variance was performed and least-squares difference post-hoc test utilized to determine where differences occurred. Significance was defined as P <.05. There was a significant reduction in total lipid peroxides between baseline and isoflavone treatments (3.22+/-0.72 vs 2.47+/-0.82 nmol/mL, P <.05). Mean systolic blood pressure was higher during isoflavone intervention than placebo (117+/-14 vs 125+/-15 mm Hg, P= .042). Supplementation with vitamin C and isoflavones did not produce a synergistic antioxidant effect. A slight but significant increase in systolic blood pressure occurred with isoflavone supplementation. A larger study should be conducted to fully explore the potential interactions between these antioxidants.