Male pattern baldness is linked to a higher risk of coronary heart disease, but only if it is on the top/crown of a man's head.

The finding came from a new study published in the journal BMJ Open which also showed that a receding hairline is not associated with an elevated risk of the disease.

The investigators searched the Medline and Cochrane Library databases for studies published on male pattern baldness and coronary heart disease. The experts found 850 potential reports that were published between 1950 and 2012.

Just 6 of the reports were included in the examination because they were the only ones that fulfilled the eligibility criteria. All studies had been published between 1993 and 2008 and included about 40,000 men.

The risk is higher for younger men

Three of the studies were cohort reports - the well-being of the balding men was monitored for 11 years or more.

Results showed that men who had lost the majority of their hair had a 32% increased risk of developing coronary artery disease, compared to their peers who maintained a full head of hair.

When the analysis was restricted to men under the age of 55-60, a comparable pattern was revealed. Bald or extensively balding males had a 44% increased probability to develop coronary artery disease.

After examining the other 3 reports, which compared the heart health of men who were bald or balding with those who were not, the experts saw similar results.

The team found that balding men had a 70% higher risk of having heart disease, while those in younger age groups had a 84% elevated chance.

The risk depends on baldness severity

Those three investigations used a validated scale (Hamilton scale) to evaluate the degree of baldness.

Baldness severity had an impact on the risk of coronary artery disease, according to the authors, but only if the baldness was on the top/crown of the head, referred to as the vertex.

The risk of developing coronary artery disease increased by:
  • 48% with extensive vertex baldness
  • 36% with moderate vertex baldness
  • 18% with mild vertex baldness
However, a receding hairline did not significantly impact the risk.

To make up for dissimilarities in the procedures of evaluating baldness in the investigations, the researchers examined 4 differing grades of baldness: none; frontal; crown-top; combined.

Similar results were seen again - the severity of baldness had an influence on the risk of coronary artery disease. A study from 2012 indicated that an abnormal quantity of a protein, Prostaglandin D2, present in the scalp of bald men, might be responsible for their hair loss.

Men with both frontal and crown-top baldness had a 69% increased risk of developing coronary artery disease than those with a full head of hair, males with only crown-top baldness had a 52% higher likelihood to develop the disease, and those with only frontal baldness had a 22% elevated chance.

Justifications for the reasons behind the link differ, the authors explained, but include the possibility that baldness may point to: "All of which are involved directly or indirectly in promoting cardiovascular disease," they said.

The researchers concluded:

"[Our] findings suggest that vertex baldness is more closely associated with systemic atherosclerosis than with frontal baldness. Thus, cardiovascular risk factors should be reviewed carefully in men with vertex baldness, especially younger men [who should] probably be encouraged to improve their cardiovascular risk profile."

Earlier this year, a link was discovered between baldness and a higher risk of prostate cancer in a study published in Cancer Epidemiology, Biomarkers & Prevention.

Written by Sarah Glynn