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
Wilson PWF, Kannel WB. Is Baldness Bad for the Heart?. JAMA. 1993;269(8):1035-1036. doi:10.1001/jama.1993.03500080083038