New research presented at the 69th Annual Conference of the Cardiological Society of India (CSI) indicated that premature greying and male-pattern baldness are linked to a greater than fivefold risk of heart disease before the age of 40. The study also suggested obesity is linked to a fourfold risk of early heart disease.
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Dr. Sachin Patil, a lead author from the U.N. Mehta Institute of Cardiology and Research Centre, Ahmedabad, India said: "The incidence of coronary artery disease in young men is increasing but cannot be explained by traditional risk factors. Premature greying and androgenic alopecia (male-pattern baldness) correlate well with vascular age irrespective of chronological age and are plausible risk factors for coronary artery disease."
The study enrolled 790 young Indian men (aged below 40 years) with coronary artery disease and 1,270 age-matched healthy men as the control group. Clinical history, including blood tests, echocardiography, electrocardiogram (ECG), and coronary angiogram, was assessed for all participants. After analyzing 24 different views of the scalp, they were provided with a male-pattern baldness score of 0 (none), 1 (mild), 2 (moderate), or 3 (severe).
Also, based on the percentage of gray/white hairs, a hair whitening score was determined—1: pure black; 2: black greater than white; 3: black equals white; 4: white greater than black; and 5: pure white.
The study analyzed the association between alopecia and premature gray hair with the severity and complexity of angiographic lesions—an indicator of coronary artery disease—and the results were compared within the two groups.
The findings indicated that young men with coronary artery disease exhibited a greater prevalence of premature graying (50% versus 30%) as well as male-pattern baldness (49% versus 27%) than the healthy controls.
Male-pattern baldness, after adjusting for age and other cardiovascular risk factors, was linked to a 5.6 times increased risk of coronary artery disease, while premature graying was linked to a 5.3 times increased risk.
Obesity, linked to a 4.1 times increased risk, was one of the strongest indicators of coronary artery disease in young Indian men next to premature graying to a and male-pattern baldness. Diabetes mellitus, higher body mass index, hypertension, central obesity, family history of premature coronary artery disease, dyslipidemia and smoking were also indicators of the disease, but to a lesser extent.
Dr. Kamal Sharma, the principal investigator and associate professor at U.N. Mehta Institute of Cardiology and Research Centre believes premature graying and baldness may point to biological, rather than chronological, age which may prove vital in determining total cardiovascular risk.
He added that to estimate biological age, which is presently estimated using common sense, a validated scale is required.
Men with premature greying and androgenic alopecia should receive extra monitoring for coronary artery disease and advice on lifestyle changes such as healthy diet, exercise, and stress management. Our study found associations but a causal relationship needs to be established before statins can be recommended for men with baldness or premature greying."
Dr Dhammdeep Humane, U.N. Mehta Institute of Cardiology and Research Centre
Professor Marco Roffi, course director of the ESC programme at CSI and head of the Interventional Cardiology Unit, Geneva University Hospital, Geneva, Switzerland, explained the need for assessment of risk factors in preventing and managing cardiovascular disease.
According to him, classical risk factors like family history of coronary disease, diabetes, smoking, high cholesterol levels, sedentary lifestyle, and high blood pressure are the major causes of cardiovascular disease and we are yet to determine if potential new risk factors such as premature graying and androgenic alopecia can improve the assessment of cardiovascular risk.