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More Bad News for Bald Men

Results from several epidemiologic studies suggest an associationbetween male pattern baldness (MPB) and coronary heart disease (CHD). The Physicians' Health Study provided an opportunity to reassess this association. In 1982, 22,071 healthy male physicians (92% white) aged 40 to 84 years enrolled in the study, and their health status continues to be followed annually. At follow-up at 11 years,19,112 men who reported that they had no cardiovascular disease when the study began were asked to identifythe hair pattern that most accurately reflected their appearance at age 45.

During the 11 years of follow-up, there were 1446 CHD events in the study group. Men with mild, moderate, or severe vertex baldness had relative risks for CHD of 1.23, 1.32, and 1.36, respectively, compared with men who did not lose hair. Vertex baldness was more strongly associated with CHD in men with hypertension (RR, 1.79) or elevated cholesterol levels (RR, 2.78). Frontal baldness was significantly associated with CHD onlyin men with hypertension (RR, 1.75). The reason for the association between MPB and CHD remains unknown, but raised androgen levels or an increased number of androgen receptors are possible explanations. The authors conclude that early vertex baldness may be a clinical marker for identifying men who need more intensive screening for hypertension and high cholesterol.

Comment: This study is limited by its reliance on recall, the specific population, and the retrospective design. However, the finding of increased risk with vertex hair loss is consistent with other research. Can 5-alpha reductase inhibitors such as finasteride reduce the risk of CHD in men with MPB? Most likely, a high number of men would need to be treated to save one life, but more work is needed to answer that question.

— NH Shear

Published in Journal Watch Dermatology March 1, 2000

Citation(s):

Lotufo PA et al. Male pattern baldness and coronary heart disease: The physician's health study. Arch Intern Med 2000 Jan 24 160 165-171.

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