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The Pharmaceutical Journal Vol 264 No 7083 p242-243
February 12, 2000 Clinical

Baldness is cardiovascular risk factor, study finds

Male pattern baldness is a marker for increased risk of coronary heart disease, particularly in men with hypertension or high cholesterol levels, say researchers from the US. Dr Paulo Lotufo (department of medicine, Harvard medical school, Massachusetts) and colleagues report in the Archives of Internal Medicine (2000;160:165) an 11-year follow-up of 22,071 men enrolled in the Physicians' Health Study. All participants were asked about their pattern of hair loss at age 45 years and any history of heart disease.
The authors found that, compared with men who had suffered no hair loss, those with frontal baldness had a relative risk of coronary heart disease of 1.23 (95 per cent confidence interval 0.94-1.25), while those with mild, moderate or severe vertex (crown of the head) baldness had relative risks of 1.23 (1.05-1.43), 1.32 (1.1-1.59) and 1.36 (1.11-1.67), respectively. In addition, vertex baldness was more strongly associated with this risk in subgroups of men who had hypertension or a high cholesterol level. In these groups the relative risks were 1.79 (1.31-2.44) and 2.78 (1.09-7.12). Frontal baldness was a significant indicator of risk only among the hypertensive subgroup, with a relative risk of 1.75 (1.24-2.48).

men with bald crowns
Men with bald crowns are more likely to suffer from coronary heart disease

The authors speculate that baldness is a risk factor either because its inheritance is linked to that of coronary heart disease or because men with severe baldness seem to have both a greater number of androgen receptors in the scalp and higher levels of total and free testosterone. They comment that high levels of androgens are thought to contribute both to atherosclerosis and thrombosis, and are associated with less favourable lipid profiles.
Dr Lotufo and colleagues note that 92 per cent of participants in the trial were white and that the results may not be applicable to other racial groups.
However, they summarise their findings by saying: "Although early vertex baldness may be a non-modifiable risk factor for coronary heart disease, it may serve as a useful clinical marker to identify men at increased risk who may benefit from aggressive screening and primary prevention efforts directed toward other known modifiable risk factors."