The report, published in JAMA (the Journal of the American Medical Association), concluded that men with typical male pattern baldness-that is, spreading outward from the crown or “vertex” of the head-are anywhere from 30 to 300 percent more likely to suffer a heart attack than men with little or no hair loss at all. There was no apparent risk for those with the receding hairlines etched by frontal baldness. And researchers were also quick to point out that what they’d found was a strictly statistical relationship between hair loss and heart disease. “We’re not saying that baldness causes heart attacks,” said Dr. Samuel Lesko, an epidemiologist at the Boston University School of Public Health, who led the study. “And we’re not saying that the treatment of baldness will alleviate heart disease.” But that still left questions about what the research is saying.
The study was commissioned in 1989 by the Upjohn Co., producer of a popular preparation called Rogaine, which claims to restore hair. The company had evidently sought the investigation after discussions with the Food and Drug Administration about possible side effects from the hair treatment, which is based on the antihypertensive drug minoxidil. BU researchers surveyed 665 men between the ages of 21 and 54 who had been hospitalized for their first heart attack, matching them against a control group who were in the hospital for other than cardiac reasons. The baldness-coronary connection they found held up even in the presence of such other known risk factors as smoking, hypertension and elevated cholesterol, What’s more, they said, “The trend of increasing risk … with increasing extent of vertex baldness is statistically significant.”
The finding is not exactly new. Investigators have been looking into the baldness-coronary link for 25 years. A JAMA editorial notes that a 1990 review of eight such studies found a possible “small risk of heart disease due to baldness,” less than that of smoking and hypertension. But the issue has remained controversial. One skeptic is cardiologist Thomas Graboys of Harvard’s Brigham and Women’s Hospital in Boston, Mass., who has studied the effects of neural stress on heart patients. Graboys thinks the findings may signify nothing more than a coincidence. “How could these things possibly be related?” he says. “Unless they are dealing with stress that is causing people to be bald and at higher risk for heart attacks.” In fact, the best guess at the moment is that a common hormonal factor underlies both problems. One likely suspect is dihydrotestosterone (DHT), which is believed to be mainly responsible for male pattern baldness. Receptors for DHT have also been found in the heart muscle.
Graboys, in any case, deplores the notion of inflicting a dubious new worry on health-obsessed Americans. “The last thing you want to do is create more psychic trauma among males that have a baldness pattern they can do nothing about,” he says.“Totally bogus, is probably what this will turn out to be.” Lesko agrees the findings must be replicated by other researchers before they cause any real concern. “I would warn anyone to be cautious about doing a lot with them at this point,” he says. “The association that we observed is significant, but it’s not large. Baldness is a relatively minor player in the bigger picture of recognized risk factors for heart disease.” Even so, Lesko and others say, it’s not a bad idea for men with hair loss of the vertex kind to pay particular attention to those other factors.
