Men with male pattern baldness -- hair loss mainly affecting the vertex or crown of the head -- face higher risks of heart attack, chest pain, and coronary artery problems that require surgical intervention. This risk is especially high in men who also have high blood pressure or high cholesterol levels. The researchers used data from the Physicians' Health Study of 22,071 apparently healthy male doctors, aged 40 and older, to evaluate the association of baldness with the risk of heart disease over an 11-year period.

Increased hair loss was associated with an increasing risk of coronary heart disease (CHD) events, the authors report. Eleven years after joining the study, men with male pattern baldness faced the following increases in CHD risk, compared to men with no hair loss: -- 9% with frontal baldness only. -- 23% with mild vertex baldness. -- 32% with moderate vertex baldness. -- 36% with severe vertex baldness. The chance of developing heart disease was even higher when the researchers combined baldness with other risk factors, the investigators note. The risk of a coronary event increased by 79% when vertex baldness was accompanied by high blood pressure and nearly tripled when joined by high cholesterol levels.

A plausible explanation for an association between baldness and CHD may be elevated androgen (male hormone) levels. Men with severe baldness appear to have more androgen levels in the scalp, and higher blood levels of testosterone. High levels of androgens may directly contribute to both atherosclerosis and thrombosis (arterial blockage due to a clot), and may adversely influence risk factors such as hypertension and high cholesterol.

Archives of Internal Medicine January 24, 2000;160:165-171.