Male baldness; association with coronary artery disease?

androgenetic alopecia who also present with particularly elevated dihydrotestosterone–testosterone ratios. The baldness theory should be included as a secondary hypothesis in large epidemiological studies of CAD. These predominantly inconclusive studies from the previous century are counterbalanced by several other positive studies performed in the current century. In 2000, Lotufo et al. [5] showed, in a retrospective cohort study among 22,071 US male physicians aged 40–84 years enrolled in the Physi-cians' Health Study, that vertex pattern baldness appeared to be a marker for increased risk of coronary events, especially among men with hypertension or high cholesterol levels. In 2001, Matilainen et al. [6] tested if the early onset of alope-cia was a risk factor for early CAD in 85 men requiring coronary revascularization, and if the early onset of androgenic alopecia differed in this respect from the late onset of male baldness. The adjusted odds ratio for the coronary revascu-larization procedure at any age was 1.84 in the subgroup of the men with early androgenetic alopecia compared to those with late androgenic alopecia or normal hair status. These results support the hypothesis that the early onset of andro-genic alopecia is a risk factor for an early onset of severe CAD. Interestingly, in 2005 Mansouri et al. [7] found an association between androgenetic alopecia and CAD in women. The study was carried out in 106 women under the age 55, who underwent coronary arteriography to diagnose CAD. The correlation of androgenetic alopecia and CAD, androgenetic alopecia and a previous history of myocardial infarction, and greying of hair and CAD were statistically significant after adjustment of data for differences in age. These data support the hypothesis that female androgenetic alopecia, like male pattern baldness, is associated with CAD in women under the age 55. In the literature, there have been conflicting reports on an association between male baldness (androgenetic alopecia) and the incidence of coronary artery disease (CAD). In 1979, Cooke [1] studied the prevalence of male pattern alopecia, CAD, hypertension, and smoking habits in 478 male Caucasian hospital inpatients over the age of 20 years. No association was shown between CAD and either male pattern alopecia, premature male pattern alopecia, or male pattern alopecia with a positive family history of CAD. In 1990, Herrera et al. [2] identified eight articles containing data on both baldness and CAD. Three of these articles were case-control studies that showed a positive relationship between baldness and …