Male-pattern baldness and premature greying are associated with a greater risk of heart disease before the age of 40 than obesity, according to a new study from India. Does this mean that doctors should be screening our hairline alongside traditional risk factors such as our weight and blood pressure?
Over the years, scientists have developed many cardiovascular disease "risk tools", with varying levels of usefulness. The tools normally involve measuring "classical" risk factors for cardiovascular disease, including high blood pressure, elevated blood cholesterol levels, obesity and diabetes. Included in most of these risk tools is age, because risk of cardiovascular disease in later life is higher if you have risk factors in your forties.
But new research suggests that two further risk factors should be added to this list: male pattern baldness and prematurely gray hair.
Results of the study — led by Dr. Kamal Sharma, who is an associate professor in the Department of Cardiology at the U.N. Mehta Institute of Cardiology and Research Centre in Ahmedabad, India — were presented at the 69th Annual Conference of the Cardiological Society of India, held in Kolkata, India.
The first author of the study is Dr. Dhammdeep Humane, who is a senior cardiology resident at the U.N. Mehta Institute of Cardiology and Research Centre.
Studying baldness and heart disease risk
Dr. Sharma and colleagues investigated 790 men younger than 40 years old who had coronary artery disease, as well as 1,270 age-matched healthy controls.
The team assessed the participants' health using an electrocardiogram, an echocardiogram, blood tests, and a coronary angiogram.
Male pattern baldness was evaluated using a score ranging from 0 (no baldness) to 1 (mild), 2 (moderate), or 3 (severe). Participants were given a score after 24 views of their scalp were analyzed.
A percentage of gray and white hairs was determined and used to give a "hair whitening score" for the participants. The researchers also examined their angiographic lesions, which are a marker of coronary artery disease.
Dr. Sharma and colleagues analyzed the link between baldness, gray hair, and the severity of the lesions in both the heart disease group and the control one.
The results show that half of the men with coronary heart disease had gray hair, compared with only 30 percent of the healthy men. And, almost half of the men (49 percent) had male pattern baldness, compared with 27 percent in the healthy group.
Extra monitoring for heart disease needed
Male pattern baldness increased the risk of coronary artery disease by 5.6 times, and premature graying by 5.3 times. By comparison, obesity increased heart disease risk by little over 4 times.
Type 2 diabetes, hypertension, a family history of heart disease, a high body mass index (BMI), high triglycerides, and smoking also predicted coronary artery disease.
"The incidence of coronary artery disease in young men," explains study co-author Dr. Sachin Patil, a third-year resident at the U.N. Mehta Institute of Cardiology and Research Centre, "is increasing but cannot be explained by traditional risk factors."
"Premature graying and [male pattern baldness]," he adds, "correlate well with vascular age irrespective of chronological age and are plausible risk factors for coronary artery disease."
Dr. Sharma echoes these thoughts, saying, "Baldness and premature graying should be considered risk factors for coronary artery disease. These factors may indicate biological, rather than chronological, age which may be important in determining total cardiovascular risk."
"Currently physicians use common sense to estimate biological age, but a validated scale is needed," he adds.
"Men with premature graying and androgenic alopecia should receive extra monitoring for coronary artery disease and advice on lifestyle changes such as healthy diet, exercise, and stress management."
Dr. Dhammdeep Humane
"Our study found associations," Dr. Humane continues, "but a causal relationship needs to be established before statins can be recommended for men with baldness or premature graying."