Isoflavones: their effects on cardiovascular risk and functions

Isoflavones - plant polyphenols with oestrogenic activity - are becoming widely distributed in foods and sold as nutriceuticals. Their similarity to steroidal oestrogens has stimulated research into potential cardiovascular benefits. The two major areas, those of lipid lowering and of improved vascular function, are reviewed.

A major plasma cholesterol lowering effect has not been sustained in recent publications. Relatively minor reductions in LDL-cholesterol or non-HDL-cholesterol have generally been reported, but studies in which no reduction was found have also been reported. Fewer publications have dealt with effects on vasculature, but these have been more consistent. Arterial compliance, a parameter of the elasticity or distensibility of large arteries, is improved by as much as has been reported for estrogens. Vasodilatory effects on the microcirculation with isoflavones or their metabolites may provide opportunities for pharmacological intervention. The metabolism of isoflavones is reviewed briefly in order to highlight its complexity.

Although research has failed to demonstrate substantial cholesterol lowering with dietary isoflavones, consumption of legumes is generally to be encouraged as part of the overall strategy for lowering plasma lipids. The favourable effects of ingested or infused isoflavones on several parameters of arterial function suggest an alternative explanation for the apparent low prevalence of coronary disease in populations that eat legumes as a staple food. A better understanding of the pharmacokinetics and bioavailabilty of individual isoflavones is needed if definitive studies are to be designed.