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Baldness and Coronary Artery Disease The Dermatologic Point of View of a Controversial Issue

Alfredo Rebora, MD
Arch Dermatol. 2001;137(7):943-947. doi:10-1001/pubs.Arch Dermatol.-ISSN-0003-987x-137-7-dre0006.
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Objective  Several articles, most of them written by nondermatologists, have stressedthat bald men have a higher risk for coronary artery disease than men whoare not bald. This study was performed to evaluate the validity of such conclusionsfrom a dermatologic point of view.

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

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

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

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