Male-Pattern Baldness Linked With Coronary Heart Disease

April 04, 2013

KYOTO, JAPAN — Vertex baldness, more commonly known as male-pattern baldness, is associated with an increased risk of coronary heart disease, according to the results of a new meta-analysis[1]. The severity of male pattern baldness increased the risk of coronary disease even in younger subjects, report investigators.

A receding hairline, on the other hand, was not associated with an increased risk of heart disease (relative risk 1.11, 95% CI 0.92–1.32; p=0.28).

"These findings suggest that vertex baldness is more closely associated with systemic atherosclerosis than . . . frontal baldness [is]," say Dr Kazuo Hara (University of Tokyo, Japan) and colleagues in their report, published online April 3, 2013 in BMJ Open. "Thus, cardiovascular risk factors should be reviewed carefully in men with vertex baldness, especially younger men, and they probably should be encouraged to improve their cardiovascular risk profile."

The researchers included six studies with 36 990 participants in the meta-analysis, including three cohort studies and three case-control studies. In the three cohort studies, the adjusted risk of coronary heart disease was 32% higher among individuals with severe vertex baldness compared with men with full hair. In the case-control studies, the risk of coronary heart disease was 70% higher among bald subjects compared with those without baldness. The increased relative risk of coronary disease was statistically significant in both analyses. When the analysis was restricted to younger subjects, those <55 or <60 years at baseline, the association between vertex baldness and coronary heart disease remained.

Three studies classified the severity of baldness. In this analysis, the risk of coronary heart disease was 48%, 36%, and 18% higher among subjects with severe, moderate, and mild vertex baldness compared with subjects without baldness. "When baldness was classified by the Hamilton-Norwood scale, which is the most commonly used classification of pattern baldness worldwide, the relationship between coronary heart disease and baldness was shown to be dependent on the severity of baldness," state the researchers.

The reason for the association between vertex baldness and coronary heart disease is not known. The current working hypothesis is that insulin resistance can impair the supply of nutrients to the hair follicles or a proinflammatory state could increase the inflammatory cytokines in the hair follicles. The researchers state that further studies are needed to confirm these findings, as well as to identify mechanisms for the association.

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