Hair Loss and Heart Disease

Jan. 23, 2000 (Los Angeles) -- Baldness may be more than just a cosmetic indignity: it could be a marker of heart disease risk, especially in men with other risk factors such as high blood pressure or high cholesterol.

Heart attacks, chest pain due to blocked arteries (called angina), and the need for balloon angioplasty or bypass surgery all are forms of heart disease, the researchers explained.

In men with high cholesterol and severe baldness at the vertex, or crown of the head, heart disease risk was increased nearly threefold compared to men who had high cholesterol but were not bald, senior author JoAnn E. Manson, MD, DrPH, tells WebMD.

High blood pressure was associated with an 80% increase in heart disease risk if the men were also bald. Mild and moderate vertex baldness were also associated with an increased risk of heart disease, but to a lesser extent. Frontal baldness -- a receding hairline -- had little relationship to heart disease. "To our knowledge, this is the first large-scale study showing a relationship between a specific pattern of baldness and heart-disease risk," Manson says. The researchers, in addition, saw that the men with more severe hair loss developed more heart disease during the 11 years they were watched than men with only mild to moderate hair loss, suggesting a link between the degree of hair loss and heart disease risk.

The biological link between hair loss and heart disease could involve elevated levels of male hormones, says Manson, an endocrinologist and chief of preventive medicine at Harvard Medical School and Brigham and Women's Hospital in Boston. The scalp has a higher density of male-hormone receptors, and high levels of hormones such as testosterone are associated with an increased risk of hardening of the arteries and blood clotting. Although this study did not include women, Manson says that true male-pattern baldness in women, which is associated with an increase in male hormones, has been linked to an increased risk of high blood pressure, diabetes, and abnormal cholesterol, all of which raise the risk of heart disease. She cautions, however, that this finding has not been well studied.

Men certainly can't change their pattern of hair loss, Manson says, "and we don't yet know if the medications used to prevent hair loss in men will decrease [heart disease] risk." However, "male-pattern baldness may be a useful marker of men who could benefit from vigilant modification of risk factors we can change. This finding could be a message for increased attention to screening and preventive measures to lower the risk of heart disease in this population."