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Baldness and Heart Disease

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Bald Man

Male pattern baldness is not particularly welcome among the chaps who would prefer their pate to remain well and truly thatched. Vanity is the prevailing driver, of course, as many balding men fear that they will look old before their time. But a recent research study published in the online medical journal BMJ Open suggests that there are more important considerations: male pattern baldness appears to be linked to an increased risk of developing coronary heart disease.

Researchers trawled medical databases for research published on male pattern baldness and coronary heart disease, and came up with 850 possible studies, published between 1950 and 2012. Of these, only six satisfied all the eligibility criteria and so these were included in the analysis. All six had been published between 1993 and 2008, and involved just under 40,000 men in total.

Three of the six studies were "cohort studies" — meaning that the health of balding men was tracked for at least 11 years.

Analysis of the findings from these showed that men who had lost most of their hair were a third more likely (32%) to develop coronary artery disease than their peers who retained a full head of hair.
When the analysis was confined to men under the age of 55-60, a similar pattern emerged. Bald or extensively balding men were 44% more likely to develop coronary artery disease.

Analysis of the other three studies, which compared the heart health of those who were bald / balding with those who were not, painted a similar picture. It showed that balding men were 70% more likely to have heart disease, and those in younger age groups were 84% more likely to do so.

Three studies assessed the degree of baldness using a validated scale (the Hamilton scale). Analysis of these results indicated that the risk of coronary artery disease depended on baldness severity, but only if this was on the top/crown of the head, known as the vertex.

Extensive vertex baldness boosted the risk by 48%, moderate vertex baldness by 36%, and mild vertex baldness by 18%. By contrast, a receding hairline made very little difference to risk, the analysis showed. In other words, the associated risk held true only if the balding was on the top/crown of the head, rather than only at the front. A receding hairline was not linked to an increased risk, the analysis indicates.

Men with both frontal and crown-top baldness were 69% more likely to have coronary artery disease than those with a full head of hair, while those with just crown-top baldness were 52% more likely to do so. Those with just frontal baldness were 22% more likely to do so.

Explanations for the reasons behind the association vary, but include the possibility that baldness may indicate insulin resistance, a precursor to diabetes; a state of chronic inflammation; or increased sensitivity to testosterone, all of which are involved directly or indirectly in promoting cardiovascular disease, say the authors.

But they conclude: "(Our) findings suggest that vertex baldness is more closely associated with systemic atherosclerosis than with frontal baldness. Thus, cardiovascular risk factors should be reviewed carefully in men with vertex baldness, especially younger men" who should "probably be encouraged to improve their cardiovascular risk profile." In other words, bald or balding men should be especially careful to follow a lifestyle that will help them to reduce their risks of developing cardiovascular disease. Here are some suggestions:

  • Do not smoke
  • Try to eat a 'Mediterranean style' diet — with plenty of fresh fruit and vegetables, oily fish and wholegrain breads and cereals
  • Minimise the consumption of foods rich is saturated (animal) fats and trans fats (especially cakes and biscuits, and many of the so-called 'fast food' offerings).
  • Choose low or reduced fat dairy products in preference to full fat options
  • Moderate your sodium (salt) intake — salt can be well disguised in many processed foods (such as packet soups, Oxo and bouillon cubes, sauces & salad dressings, Marmite, salami, bacon & cured meats, sun dried tomatoes, most cheeses, crisps and snackfoods, and some breakfast cereals — so read the labels carefully!
  • Increase your consumption of potassium-rich foods like Dark Leafy Greens (especially Spinach), Baked Potatoes (with Skins), Dried Apricots, Yogurt (Low-Fat), Fresh Fish (especially Salmon — but not smoked, which is very salty) Avocados and Bananas
  • Try to take regular exercise — ideally every day, but at the very least enough physical activity to make you breathless for 20 minutes, three times a week
  • Moderate your alcohol intake, and have at least two or three 'alcohol-free' days per week
  • Seek to maintain your body weight within healthy range (a BMI of 18.5 — 25) — to assess your current BMI, click here
  • Have your blood pressure and cholesterol levels checked at least every two or three years, and if prescribed medication, adhere closely to the defined regime
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