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February 24, 1993, Vol 269, No. 8 >
ARTICLE | February 24, 1993

A Case-Control Study of Baldness in Relation to Myocardial Infarction in Men FREE

Samuel M Lesko, MD; Lynn Rosenberg, ScD; Samuel Shapiro, MB, FRCP(Edin)
[+] Author Affiliations

Reprint requests to Slone Epidemiology Unit, 1371 Beacon St, Brookline, MA 02146 (Dr Lesko).


JAMA. 1993;269(8):998-1003. doi:10.1001/jama.1993.03500080046030
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References

Objective.  —To examine the relationship between male pattern baldness and the risk of myocardial infarction in men under the age of 55 years.

Design and Participants.  —A hospital-based, case-control study was conducted in eastern Massachusetts and Rhode Island. Cases were men admitted to a hospital for a first nonfatal myocardial infarction (n=665); controls were men admitted to the same hospitals with noncardiac diagnoses (n=772). Extent of baldness was assessed using the 12-point modified Hamilton Baldness Scale; other information was obtained by personal interview. Among the controls, the prevalence of any baldness was 34%, while the prevalence of baldness involving the vertex scalp was 23%.

Results.  —After allowing for age, the relative risk estimate for frontal baldness compared with no hair loss was 0.9 (95% confidence interval, 0.6 to 1.3), for baldness involving the vertex scalp it was 1.4 (95% confidence interval, 1.2 to 1.9). Risk of myocardial infarction increased as the degree of vertex baldness increased (P<.01); for severe vertex baldness the relative risk was 3.4 (95% confidence interval, 1.7 to 7.0). The relationship between vertex baldness and myocardial infarction was consistent within strata defined by age and other risk factors for coronary artery disease.

Conclusion.  —These data support the hypothesis that male pattern baldness involving the vertex scalp is associated with coronary artery disease in men under the age of 55 years.(JAMA. 1993;269:998-1003)

REFERENCES

1 +
Buechner HA, Brown M, Tretola RJ.  Baldness and emphysema. J Louisiana State Med Soc . 1964;; 116:329-332.
2 +
Cotton SG, Nixon JH, Carpenter RG, Evans DW.  Factors discriminating men with coronary heart disease from healthy controls. Br Heart J . 1972;;34:458-464.
3 +
 Predicting coronary artery disease. BMJ . 1972;; 4:3. Leading article.
4 +
Hamilton JB.  Male hormone stimulation is a prerequisite and an incitant in common baldness. Am J Anat . 1942;;71:451-479.
5 +
Reynolds JEF, ed. Martindale: The Extra Pharmacopoeia . 29th ed. London, England: Pharmaceutical Press; 1989;:491-492.
6 +
Herman EH, Balazs T, Young R, Earl FL, Krop S, Ferrans VI.  Acute cardiomyopathy induced by the vasodilating antihypertensive agent minoxidil. Toxicol Appi Pharmacol . 1979;;47:493-503.
7 +
Balazs T, Payne BJ.  Myocardial papillary muscle necrosis induced by hypotensive agents in dogs. Toxicol Appi Pharmacol . 1971;;20:442-445.
8 +
Haynes SG, Levine S, Scotch N, Feinleib M, Kannel WB.  The relationship of psychosocial factors to coronary heart disease in the Framingham Study, I: methods and risk factors. Am J Epidemiol . 1978;;107:362-383.
9 +
Norwood OT.  Male pattern baldness: classification and incidence. South Med J . 1975;;68:1359-1365.
10 +
Ischemic Heart Disease Registers: Report of the Fifth Working Group . Copenhagen, Denmark: World Health Organization; 1971;.
11 +
Mantel N, Haenszel W.  Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst . 1959;;22:719-748.
12 +
Miettinen OS.  Estimability and estimation in case-referent studies. Am J Epidemiol . 1976;;103: 226-235.
13 +
Armitage P. Statistical Methods in Medical Research . New York, NY: John Wiley & Sons Inc; 1971;:319-320.
14 +
Halim MM, Meyrick G, Jeans WD, Murphy D, Burton JL.  Myocardial infarction, androgen and the skin. Br J Dermatol . 1978;;98:63-68.
15 +
Cooke NT.  Male pattern alopecia and coronary artery disease in men. Br J Dermatol . 1979;;101: 455-458.
16 +
Persson B, Johansson BW.  The Kockum study: twenty-two year follow-up: coronary heart disease in a population in the south of Sweden. Acta Med Scand . 1984;;216:485-493.
17 +
Trevisan M, Jossa F, Krogh V, et al.  Baldness and coronary heart disease risk factors. Circulation . 1990;;81:18. Abstract.
18 +
Tenover JS.  Prostates, pates, and pimples: the potential medical uses of steroid 5 alpha-reductase inhibitors. Endocrinol Metab Clin North Am . 1991;; 20:893-909.
19 +
Sheridan PJ, McGill HC, Aufdemorte TB, Triplett RG, Holt RG.  Heart contains receptors for dihydrotestosterone but not testosterone: possible role in the sex differential in coronary heart disease. Anat Rec . 1989;;223:414-419.
20 +
McGill HC, Anselmo VC, Buchanan JH, Sheridan PJ.  The heart is a target organ for androgen. Science . 1980;;207:775-777.
21 +
Greger NG, Insull W, Probstfield JL, Keenan BS.  High-density lipoprotein response to 5-alphadihydrotestosterone in Macaca fascicularis: a hormone-responsive primate model for the study of atherosclerosis. Metabolism . 1990;;39:919-924.
22 +
Hamalainen E, Adlercreutz H, Ehnholm C, Puska P.  Relationships of serum lipoproteins and apoproteins to sex hormones and to the binding capacity of sex hormone binding globulin in healthy Finnish men. Metabolism . 1986;;35:535-541.
23 +
Vermeulen A, Deslypere JP.  Long-term transdermal dihydrotestosterone therapy: effects on pituitary gonadal axis and plasma lipoproteins. Maturitas . 1985;;7:281-287.
24 +
Gormley GJ, Stoner E, Rittmaster RS, et al.  Effects of finasteride (MK-906), a 5 alpha-reductase inhibitor, on circulating androgens in male volunteers. J Clin Endocrinol Metab . 1990;;70:1136-1141.
25 +
Phillips GB.  Evidence for hyperestrogenaemia as a risk factor for myocardial infarction in men. Lancet . 1976;;2:14-15.
26 +
Heller RF, Jacobs HS, Vermeulen A, Deslypere JP.  Androgens, oestrogens, and coronary heart disease. BMJ . 1981;;282:438-439.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Buechner HA, Brown M, Tretola RJ.  Baldness and emphysema. J Louisiana State Med Soc . 1964;; 116:329-332.
2 +
Cotton SG, Nixon JH, Carpenter RG, Evans DW.  Factors discriminating men with coronary heart disease from healthy controls. Br Heart J . 1972;;34:458-464.
3 +
 Predicting coronary artery disease. BMJ . 1972;; 4:3. Leading article.
4 +
Hamilton JB.  Male hormone stimulation is a prerequisite and an incitant in common baldness. Am J Anat . 1942;;71:451-479.
5 +
Reynolds JEF, ed. Martindale: The Extra Pharmacopoeia . 29th ed. London, England: Pharmaceutical Press; 1989;:491-492.
6 +
Herman EH, Balazs T, Young R, Earl FL, Krop S, Ferrans VI.  Acute cardiomyopathy induced by the vasodilating antihypertensive agent minoxidil. Toxicol Appi Pharmacol . 1979;;47:493-503.
7 +
Balazs T, Payne BJ.  Myocardial papillary muscle necrosis induced by hypotensive agents in dogs. Toxicol Appi Pharmacol . 1971;;20:442-445.
8 +
Haynes SG, Levine S, Scotch N, Feinleib M, Kannel WB.  The relationship of psychosocial factors to coronary heart disease in the Framingham Study, I: methods and risk factors. Am J Epidemiol . 1978;;107:362-383.
9 +
Norwood OT.  Male pattern baldness: classification and incidence. South Med J . 1975;;68:1359-1365.
10 +
Ischemic Heart Disease Registers: Report of the Fifth Working Group . Copenhagen, Denmark: World Health Organization; 1971;.
11 +
Mantel N, Haenszel W.  Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst . 1959;;22:719-748.
12 +
Miettinen OS.  Estimability and estimation in case-referent studies. Am J Epidemiol . 1976;;103: 226-235.
13 +
Armitage P. Statistical Methods in Medical Research . New York, NY: John Wiley & Sons Inc; 1971;:319-320.
14 +
Halim MM, Meyrick G, Jeans WD, Murphy D, Burton JL.  Myocardial infarction, androgen and the skin. Br J Dermatol . 1978;;98:63-68.
15 +
Cooke NT.  Male pattern alopecia and coronary artery disease in men. Br J Dermatol . 1979;;101: 455-458.
16 +
Persson B, Johansson BW.  The Kockum study: twenty-two year follow-up: coronary heart disease in a population in the south of Sweden. Acta Med Scand . 1984;;216:485-493.
17 +
Trevisan M, Jossa F, Krogh V, et al.  Baldness and coronary heart disease risk factors. Circulation . 1990;;81:18. Abstract.
18 +
Tenover JS.  Prostates, pates, and pimples: the potential medical uses of steroid 5 alpha-reductase inhibitors. Endocrinol Metab Clin North Am . 1991;; 20:893-909.
19 +
Sheridan PJ, McGill HC, Aufdemorte TB, Triplett RG, Holt RG.  Heart contains receptors for dihydrotestosterone but not testosterone: possible role in the sex differential in coronary heart disease. Anat Rec . 1989;;223:414-419.
20 +
McGill HC, Anselmo VC, Buchanan JH, Sheridan PJ.  The heart is a target organ for androgen. Science . 1980;;207:775-777.
21 +
Greger NG, Insull W, Probstfield JL, Keenan BS.  High-density lipoprotein response to 5-alphadihydrotestosterone in Macaca fascicularis: a hormone-responsive primate model for the study of atherosclerosis. Metabolism . 1990;;39:919-924.
22 +
Hamalainen E, Adlercreutz H, Ehnholm C, Puska P.  Relationships of serum lipoproteins and apoproteins to sex hormones and to the binding capacity of sex hormone binding globulin in healthy Finnish men. Metabolism . 1986;;35:535-541.
23 +
Vermeulen A, Deslypere JP.  Long-term transdermal dihydrotestosterone therapy: effects on pituitary gonadal axis and plasma lipoproteins. Maturitas . 1985;;7:281-287.
24 +
Gormley GJ, Stoner E, Rittmaster RS, et al.  Effects of finasteride (MK-906), a 5 alpha-reductase inhibitor, on circulating androgens in male volunteers. J Clin Endocrinol Metab . 1990;;70:1136-1141.
25 +
Phillips GB.  Evidence for hyperestrogenaemia as a risk factor for myocardial infarction in men. Lancet . 1976;;2:14-15.
26 +
Heller RF, Jacobs HS, Vermeulen A, Deslypere JP.  Androgens, oestrogens, and coronary heart disease. BMJ . 1981;;282:438-439.

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