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Study links male-pattern baldness to heart disease

Thursday April 4, 2013
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Male-pattern baldness is linked to an increased risk of coronary heart disease, but only if the baldness is on the crown of the head instead of the front, according to a data analysis.

A receding hairline is not linked to an increased risk, according to the study published April 3 in the online journal BMJ Open.

Researchers with the University of Tokyo checked the Medline and Cochrane Library databases for research published on male-pattern baldness and coronary heart disease, and came up with 850 possible studies published between 1950 and 2012. Only six satisfied all the eligibility criteria and were included in the analysis. All had been published between 1993 and 2008, and totaled just under 40,000 men.

Three of the studies were cohort studies, with the health of balding men tracked for at least 11 years. Analysis of the findings from those studies showed that men who had lost most of their hair were 32% more likely to develop coronary artery disease than their peers who retained a full head of hair. When the analysis was confined to men younger than 55 to 60, bald or extensively balding men were 44% more likely to develop coronary artery disease.

Analysis of the three other studies, which compared the heart health of those who were bald or balding with those who were not, painted a similar picture. Balding men were 70% more likely to have heart disease, and those in younger age groups were 84% more likely.

Three studies assessed the degree of baldness using a validated scale (the Hamilton scale). Analysis of these results indicated that the risk of coronary artery disease depended on baldness severity, but only if the baldness was on the crown of the head, also known as the vertex.

Extensive vertex baldness boosted the risk by 48%, moderate vertex baldness by 36% and mild vertex baldness by 18%. By contrast, a receding hairline made very little difference to risk, the analysis showed.

To compensate for differences in the methods of assessing baldness in the studies included in the analysis, the researchers looked at four differing grades of baldness: none, frontal, crown/top and combined.

Again, findings indicated that the severity of baldness affected the risk of coronary heart disease. Men with both frontal and crown-top baldness were 69% more likely to have coronary artery disease than those with a full head of hair, while those with only crown-top baldness were 52% more likely and those with only frontal baldness were 22% more likely.

Explanations for the reasons behind the association vary, but include the possibility that baldness may indicate insulin resistance, a precursor to diabetes; a state of chronic inflammation; or increased sensitivity to testosterone. Each of those factors is involved directly or indirectly in promoting cardiovascular disease, the authors noted.

"Cardiovascular risk factors should be reviewed carefully in men with vertex baldness, especially younger men," who should "probably be encouraged to improve their cardiovascular risk profile," the authors concluded.

The study is available at http://bmjopen.bmj.com/content/3/4/e002537.full.

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