Baldness and coronary artery disease: the dermatologic point of view of a controversial issue

Arch Dermatol. 2001 Jul;137(7):943-7.


Objective: Several articles, most of them written by nondermatologists, have stressed that bald men have a higher risk for coronary artery disease than men who are not bald. This study was performed to evaluate the validity of such conclusions from a dermatologic point of view.

Design: A review of the 24 articles in literature from 1954 to 1999 as provided by MEDLINE and a previous review.

Results: Five articles contained simple comments; 1 was a review of the previous literature; and 3 dealt only with the lipid profile. The remaining 15 articles dealt with coronary artery disease and baldness, and 9 of these concluded that there is a relationship between the 2 conditions, especially in younger subjects with severe early-onset androgenetic alopecia.

Conclusions: Baldness did not coincide with androgenetic alopecia in some of the articles examined, which makes it difficult to settle the issue. Subjects who develop baldness before their 30s may have a higher risk for coronary artery disease than other men, and they may be individuals with early-onset androgenetic alopecia who also present with particularly elevated dihydrotestosterone-testosterone ratios. The baldness theory should be included as a secondary hypothesis in large epidemiological studies of coronary artery disease. Such studies should include dermatologic expertise for accurate, cost-effective evaluation of baldness.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Adult
  • Age of Onset
  • Aged
  • Alopecia / classification
  • Alopecia / epidemiology*
  • Bias
  • Case-Control Studies
  • Cohort Studies
  • Comorbidity
  • Confidence Intervals
  • Coronary Disease / epidemiology*
  • Coronary Disease / mortality*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Prospective Studies
  • Reproducibility of Results
  • Research Design
  • Risk Assessment
  • Sample Size