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

Is Baldness Bad for the Heart? FREE

Peter W. F. Wilson, MD; William B. Kannel, MD
[+] Author Affiliations

Reprint requests to Framingham Heart Study, 5 Thurber St, Framingham, MA 01701 (Dr Wilson).


JAMA. 1993;269(8):1035-1036. doi:10.1001/jama.1993.03500080083038
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References

The article by Lesko et al1 in this issue presents data suggesting that male pattern baldness in men under 55 years of age is associated with an increased risk of myocardial infarction (MI). Baldness is a common trait, affecting approximately one third of middle-aged men; thus, this report merits comment and discussion. There are a number of issues to consider: (1) What epidemiologic evidence is required to consider baldness as an MI or a coronary heart disease (CHD) risk factor? (2) What is the historical perspective for other physical findings that were initially suggested as CHD risk factors? (3) Do biologically plausible mechanisms underlie the baldness-CHD link? (4) What advice should be given to patients?

Epidemiologic Evidence for Baldness as a CHD Risk Factor  Cardiovascular population researchers are constantly looking for new factors that might be associated with disease. Initial associations are typically reported in a small clinicalSee

REFERENCES

1 +
Lesko SM, Rosenberg L, Shapiro S.  A case-control study of baldness in relation to myocardial infarction in men. JAMA . 1993;;269:998-1003.
2 +
Abbott RD, Wilson PWF, Kannel WB, Castelli WP.  High density lipoprotein cholesterol, total cholesterol, and myocardial infarction: the Framingham Study. Arteriosclerosis . 1988;;8:207-211.
3 +
Gordon DJ, Probstfield JL, Garrison RJ, et al.  High-density lipoprotein cholesterol and cardiovascular disease: four prospective American studies. Circulation . 1988;;79:1-8.
4 +
Herrera CR, Lynch C.  Is baldness a risk factor for coronary artery disease? a review of the literature. J Clin Epidemiol . 1990;;43:1255-1260.
5 +
Herrera C, D'Agostino RB, Bosco L, Belanger A, Gerstman B, Kannel WB. Baldness and coronary heart disease in Framingham men. Read before a meeting of the Society of General Internal Medicine; January 30, 1992; New Orleans, La.
6 +
Hopkins PN, Williams RR.  A survey of 246 suggested coronary risk factors. Atherosclerosis . 1981;;40:1-52.
7 +
Brown MS, Goldstein JL.  A receptor-mediated pathway for cholesterol homeostasis. Science . 1986;;232:34-47.
8 +
Schaefer EJ, Levy RI.  Pathogenesis and management of lipoprotein disorders. N Engl J Med . 1985;;312:1300-1309.
9 +
Vague J.  The degree of masculine differentiation of obesities: a factor determining predisposition to diabetes, atherosclerosis, gout, and uric calculous disease. Am J Clin Nutr . 1956;;4:20-34.
10 +
Ducimetiere P, Richard J, Cambien F.  The pattern of subcutaneous fat distribution in middle-aged men and the risk of coronary heart disease: the Paris Prospective Study. Int J Obes . 1986;;10:229-240.
11 +
Donahue RP, Abbott RD, Bloom E, Reed D, Yano K.  Central obesity and coronary heart disease in men. Lancet . 1987;;1:821-824.
12 +
McKeigue PM, Miller GJ, Marmot MG.  Coronary heart disease in South Asians overseas: a review. J Clin Epidemiol . 1989;;42:597-609.
13 +
Stern MP, Haffner SM.  Body fat distribution and hyperinsulinemia as risk factors for diabetes and cardiovascular disease. Arteriosclerosis . 1986;;6:123-130.
14 +
Kannel WB, Wilson PWF.  Efficacy of lipid profiles in predicting coronary disease. Am Heart J . 1992;;124:768-774.
15 +
Zavaroni I, Bonora E, Pagliara M, et al.  Risk factors for coronary artery disease in healthy persons with hyperinsulinemia and normal glucose tolerance. N Engl J Med . 1989;;320:702-706.
16 +
Tenover JS.  Prostates, pates, and pimples: the potential medical uses of steroid 5 alpha-reductase inhibitors. Endocrinol Metabol Clin North Am . 1991;;20:893-909.
17 +
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. Abstract.
18 +
McConnell JD, Wilson JD, George FW, Geller J, Pappas F, Stoner E.  Finasteride, an inhibitor of 5 alpha-reductase, suppresses prostatic dihydrotestosterone in men with benign prostatic hyperplasia. J Clin Endocrinol Metab . 1992;;74:505-508.
19 +
Price VH.  Testosterone metabolism in the skin: a review of its function in androgenetic alopecia, acne vulgaris, and idiopathic hirsutism including recent studies with antiandrogens. Arch Dermatol . 1975;;111:1496-1502.
20 +
National Cholesterol Education Program Expert Panel.  Report of the National Cholesterol Education Program Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults. Arch Intern Med . 1988;;148:36-69.

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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 +
Lesko SM, Rosenberg L, Shapiro S.  A case-control study of baldness in relation to myocardial infarction in men. JAMA . 1993;;269:998-1003.
2 +
Abbott RD, Wilson PWF, Kannel WB, Castelli WP.  High density lipoprotein cholesterol, total cholesterol, and myocardial infarction: the Framingham Study. Arteriosclerosis . 1988;;8:207-211.
3 +
Gordon DJ, Probstfield JL, Garrison RJ, et al.  High-density lipoprotein cholesterol and cardiovascular disease: four prospective American studies. Circulation . 1988;;79:1-8.
4 +
Herrera CR, Lynch C.  Is baldness a risk factor for coronary artery disease? a review of the literature. J Clin Epidemiol . 1990;;43:1255-1260.
5 +
Herrera C, D'Agostino RB, Bosco L, Belanger A, Gerstman B, Kannel WB. Baldness and coronary heart disease in Framingham men. Read before a meeting of the Society of General Internal Medicine; January 30, 1992; New Orleans, La.
6 +
Hopkins PN, Williams RR.  A survey of 246 suggested coronary risk factors. Atherosclerosis . 1981;;40:1-52.
7 +
Brown MS, Goldstein JL.  A receptor-mediated pathway for cholesterol homeostasis. Science . 1986;;232:34-47.
8 +
Schaefer EJ, Levy RI.  Pathogenesis and management of lipoprotein disorders. N Engl J Med . 1985;;312:1300-1309.
9 +
Vague J.  The degree of masculine differentiation of obesities: a factor determining predisposition to diabetes, atherosclerosis, gout, and uric calculous disease. Am J Clin Nutr . 1956;;4:20-34.
10 +
Ducimetiere P, Richard J, Cambien F.  The pattern of subcutaneous fat distribution in middle-aged men and the risk of coronary heart disease: the Paris Prospective Study. Int J Obes . 1986;;10:229-240.
11 +
Donahue RP, Abbott RD, Bloom E, Reed D, Yano K.  Central obesity and coronary heart disease in men. Lancet . 1987;;1:821-824.
12 +
McKeigue PM, Miller GJ, Marmot MG.  Coronary heart disease in South Asians overseas: a review. J Clin Epidemiol . 1989;;42:597-609.
13 +
Stern MP, Haffner SM.  Body fat distribution and hyperinsulinemia as risk factors for diabetes and cardiovascular disease. Arteriosclerosis . 1986;;6:123-130.
14 +
Kannel WB, Wilson PWF.  Efficacy of lipid profiles in predicting coronary disease. Am Heart J . 1992;;124:768-774.
15 +
Zavaroni I, Bonora E, Pagliara M, et al.  Risk factors for coronary artery disease in healthy persons with hyperinsulinemia and normal glucose tolerance. N Engl J Med . 1989;;320:702-706.
16 +
Tenover JS.  Prostates, pates, and pimples: the potential medical uses of steroid 5 alpha-reductase inhibitors. Endocrinol Metabol Clin North Am . 1991;;20:893-909.
17 +
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. Abstract.
18 +
McConnell JD, Wilson JD, George FW, Geller J, Pappas F, Stoner E.  Finasteride, an inhibitor of 5 alpha-reductase, suppresses prostatic dihydrotestosterone in men with benign prostatic hyperplasia. J Clin Endocrinol Metab . 1992;;74:505-508.
19 +
Price VH.  Testosterone metabolism in the skin: a review of its function in androgenetic alopecia, acne vulgaris, and idiopathic hirsutism including recent studies with antiandrogens. Arch Dermatol . 1975;;111:1496-1502.
20 +
National Cholesterol Education Program Expert Panel.  Report of the National Cholesterol Education Program Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults. Arch Intern Med . 1988;;148:36-69.

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