Baldness and premature greying 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.
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Male-pattern baldness and premature greying associated with risk of early heart disease
Today marks the start of the 69th Annual Conference of the Cardiological Society of India (CSICon2017) where they are due to reveal that male-pattern baldness and premature greying are associated with risk of early heart disease.
The study included 790 Indian men below the age of 40 with coronary artery disease and compared them with a control group of healthy age-matched men. Each of the individuals in the research underwent an electrocardiogram (ECG), echocardiography, blood tests and coronary angiogram as well as a full clinical history.
A male-pattern baldness rating was assigned to each participant where 0 = none, 1 = mild and 2 = moderate and 3 = severe, and a hair whitening score was attributed based on the percentage of grey and white hairs where 1 = pure black, 2 = black greater than white, 3 = black and white in equal measure, 4 = more white than black and 5 = pure white.
Researchers compared the complexity and severity of angiographic lesions (an indicator of coronary artery disease) with premature grey hair and alopecia to identify any correlation. The study reveals that young Indian men with coronary artery disease had a higher prevalence of premature greying (50% versus 30%) and male pattern-baldness (49% versus 27%) compared with the healthy control group.
Male pattern-baldness was associated with a 5.6 times greater risk of coronary artery disease and premature greying was associated with a 5.3 times greater risk.
Diabetes mellitus, hypertension, family history of premature coronary artery disease, central obesity, higher body mass index, dyslipidaemia and smoking were also revealed to correlate to coronary artery disease, with obesity being the most prominent predicter of coronary artery disease after male-pattern baldness and premature greying.
Men with premature greying and androgenic alopecia should receive extra monitoring for coronary artery disease and advice on lifestyle changes such as healthy diet, exercise, and stress management. Our study found associations but a causal relationship needs to be established before statins can be recommended for men with baldness or premature greying.
It is an established fact that premature coronary artery disease is becoming more common in India with each passing day. We do not know the exact reasons behind this. The present study suggesting that premature greying and male-pattern baldness could be important risk factors goes a long way in our understanding of this riddle.
Assessment of risk factors is critical in the prevention and management of cardiovascular disease. Classical risk factors such as diabetes, family history of coronary disease, smoking, sedentary lifestyle, high cholesterol levels and high blood pressure are responsible for the vast majority of cardiovascular disease. It remains to be determined whether potential new risk factors, like the ones described, may improve cardiovascular risk assessment.
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