Male pattern baldness and coronary heart disease - The physicians' health study

Objective: To examine the association between male pattern baldness and the risk of coronary heart disease (CHD) events. Design, Setting, and Participants: Retrospective cohort study among 22 071 US male physicians aged 40 to 84 years enrolled in the Physicians' Health S tudy. Of these, 19 112 were free of CHD at baseline and completed a questio nnaire at the Ii-year follow-up concerning their pattern of hair loss at ag e 45 years. Response options included no hair loss, frontal baldness only, or frontal baldness with mild, moderate, or severe vertex baldness. Main Outcome Measures: Coronary heart disease events defined as nonfatal my ocardial infarction (MI), angina pectoris, and/or coronary revascularizatio n. Results: During 11 years of follow-up, we documented 1446 CHD events in thi s cohort. Compared with men with no hair loss, those with frontal baldness had an adjusted relative risk (RR) of CHD of 1.09 (95% confidence interval [Cl], 0.94-1.25), while those with mild, moderate, or severe vertex baldnes s had RRs of 1.23 (95% CI, 1.05-1.43), 1.32 (95% CI, 1.10-1.59),and 1.36 (9 5% CI, 1.11-1.67), respectively (P for trend, <.001). Multivariate adjustme nt for age, parental history of MI, height, body mass index (weight in kilo grams divided by the square of the height in meters as a continuous variabl e), smoking, history of hypertension, diabetes, high cholesterol level, phy sical activity, and alcohol intake did not materially alter these associati ons. Results were similar when nonfatal MI, angina, and coronary revascular ization were examined separately, and when events were analyzed among men o lder and younger than 55 years at baseline. Vertex baldness was more strong ly associated with CHD risk among men with hypertension (multivariate RR, 1 .79; 95% CI, 1.31-2.44) or high cholesterol levels (multivariate RR, 2.78; 95% CI, 1.09-7.12). Conclusion: Vertex pattern baldness appears to be a marker for increased ri sk of CHD events, especially among men with hypertension or high cholestero l levels.