Androgenetic alopecia has been associated with several other medical conditions including coronary heart disease, enlargement of the prostate in men and an increased risk of polycystic ovary syndrome (PCOS) in women.
Coronary artery disease
For a long time there has been an indication that bald men have a higher risk for coronary artery disease than men who are not bald. Several documented studies carried out by researchers thereafter have revealed that there is a possible clinical association between androgenetic alopecia and coronary artery disease (CAD) in men and probably women too.
- Lesko and colleagues documented a case-controlled study of 655 men aged 21 to 54 admitted to the hospital with their first myocardial infarction (heart attack). They were compared with patients of similar age admitted for non-cardiac conditions who did not have a history of prior cardio-vascular problems. The team observed that vertex (top of the head) but not frontal baldness was associated with an increased risk of myocardial infarction, which increased with the extent of vertex baldness. The age-adjusted relative risk of a myocardial infarction was 1.3 for mild to moderate vertex baldness and 3.4 for severe vertex baldness.
- Schnohr et al, in a 12-year follow-up of 11,674 men between 30 to 79 years of age, found that both vertex and especially fronto-parietal baldness was associated with increased risk of myocardial infarction.
- Lotufo et al. in one of the largest studies during an 11-year period showed an association between severity of baldness and coronary artery disease. A retrospective cohort study (i.e. A research study in which the medical records of groups of individuals who are alike in many ways but differ by a certain characteristic) of 19,112 male physicians 40 – 84 years old who were free of congestive heart disease at baseline and who completed a questionnaire visually matching hair loss with pictorial representations of baldness was carried out by these researchers. It was found that men with male pattern baldness had an increased risk of coronary artery disease (relative risk for frontal loss 1.09 and severe vertex loss 1.36).
- Herrera and colleagues reported on 2017 men in the Framingham study who were assessed in 1956 and 1962 for extent of baldness and observed for 30 years for any cardiovascular disease. The results showed that although the extent of baldness was not correlated with coronary artery disease, the amount of and progression of baldness was associated with the occurrence of coronary artery disease.
- Although the study of Ford and colleagues found baldness to be not associated with an increased total rate of coronary artery disease incidence or mortality, in men younger than age 55 severe baldness was positively associated with coronary artery disease mortality and somewhat less associated with incidence.
- Trevisan et al. in their study on heart disease risk factors concluded that patients with fronto-occipital baldness had on the average higher levels of serum cholesterol and blood pressure compared to participants of similar age with no baldness.
However, the relationship between androgenetic alopecia and coronary artery disease in men is still a controversial issue.
It is not known exactly how androgen is involved in prostate cancer etiology, but because male pattern baldness and prostate cancer are both androgen dependent processes, the question has been raised of the potential association of these phenotypes. The prostate is a chestnut-shaped body that surrounds the beginning of the male urethra at the base of the bladder. Several studies have been conducted to establish the relation between the two conditions, and variability in the 5aR-2 gene has been suggested as a potential explanation for the racial and ethnic variability in prostate cancer risk.
Conditions and diseasesa Associated with androgenetic alopecia In women
The association between androgenetic alopecia and coronary artery disease in men has been documented, but few studies, if any, have focused on this association in women. Iron deficiency has been associated with hair loss and may play a role in the response that women with male-pattern baldness have no treatment. In women, androgenetic alopecia is associated with an increased risk of polycystic ovary syndrome (PCOS). Polycystic ovary syndrome is characterized by a hormonal imbalance that can lead to irregular menstruation, acne, excess body hair (hirsutism), and weight gain.