Are Balding Men at Risk?

Last Editorial Review: 5/4/2005

Are Balding Men at Risk?

By Dean Haycock
WebMD Feature

July 27, 2001 -- For years, I thought the battle between me and my thinning hair was waged on one front: my forehead. But my genes opened a second front without warning. Seeing the back of my head one day in a restaurant with far too many mirrors, I saw a devastated terrain far beyond my receding hairline. The war was over. I had a classic case of male pattern baldness, in front and on top of my head.

I quickly accepted the terms offered by nature. I even achieved a state of peace when I read Sean Connery's advice to balding men. Upon being crowned People magazine's "Sexiest Man Alive" in 1989, Connery said just leave your head be "and you don't have a problem." So Sean and I have let our heads be.

Now, after more than a decade, there is a reason to reconsider my thinning hair. A report in the Jan. 24, 2000, issue of Archives of Internal Medicine suggests that the type of baldness a man experiences by age 45 may be linked to a greater risk for developing heart disease. Since we can't do anything to change our thinning hair and genes, guys like myself may want to take extra steps to reduce other risk factors for heart disease. This is the kind of report that makes me wonder, "Should I stop thinking about exercising every day and actually do it?"

It would be easier to avoid exercise if the study was not so convincing. Researcher JoAnn Manson, MD, DPH, professor of medicine at Harvard Medical School and chief of preventive medicine at Brigham and Women's Hospital in Boston, and her colleagues actually studied more than 19,000 men over a period of 11 years. They found that men with hair loss on the top of their heads had a 34% increased risk for developing heart disease when compared with men who had no hair loss or men with only receding hairlines.

The implications of the findings don't impress Philip Greenland, MD, spokesman for the American Heart Association and chairman of the department of preventive medicine at Northwestern University Medical School in Chicago. "The additional risk is quite modest," he says. "To put it into some perspective, a person who has elevated cholesterol vs. a person who has normal cholesterol has about a doubling, or in some cases even a tripling of the risk. So that would be a 200% (or 300%) increase."

But if balding men have other risk factors, they might want to pay some attention to Manson's findings. Men with high blood pressure and extensive baldness, for instance, have an 80% increased risk compared with men with high blood pressure and full heads of hair. Worse, men with extensive baldness and high cholesterol have nearly a threefold higher risk compared with men with hair and high cholesterol.

And, no, the risks do not appear to be reduced by any treatment that regrows hair, Manson says.

As a devotee of the "forget about it" school of baldness management, I never considered slathering my head with hair lotions, anyway. But this new study made me reconsider my lifelong, off-and-on-again effort to get daily exercise.

Maurizio Trevisan, MD, professor and chairman of the department of social and preventive medicine at SUNY Buffalo, suggests that may be a good idea. "This should not be interpreted as saying bald people are doomed," he says. "The most important finding ... is that if you are bald, that is another incentive to check your cardiovascular risk. You can do a lot to control other risk factors."

Manson agrees. "People with this pattern of hair loss may want to be particularly attentive to risk factors for heart disease that can be changed," he suggests. These include the familiar admonitions to treat high blood pressure, lower high cholesterol, exercise regularly, avoid smoking, and eat a heart-healthy diet.

Aside from a borderline cholesterol level and less than daily exercise, I had most of these covered before I read Manson's paper. Her data may inspire me to pull out the NordicTrack#153; every day and cut even more cholesterol from my diet. But nothing will ever convince me to do anything other than leave my head be. Sean and I are together on that.

Dean A. Haycock is a freelance science and medical writer based in Salem, N.Y. His work has appeared frequently in WebMD.

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