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PLoS One. 2019 Nov 19;14(11):e0225521. doi: 10.1371/journal.pone.0225521. eCollection 2019.

Male-pattern baldness and incident coronary heart disease and risk factors in the Heinz Nixdorf Recall Study.

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Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany.
Institute of Human Genetics, University of Bonn, Bonn, Germany.
Department of Genomics, Life & Brain GmbH, University of Bonn, Bonn, Germany.
Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Essen, Germany.
Centre for Urbane Epidemiology, University Hospital Essen, Essen, Germany.


Male-pattern baldness (MPB) is characterized by a progressive hair loss from the frontal and vertex scalp that affects about 80% of men at the age of 80 years. Epidemiological studies show positive associations between MPB and coronary heart disease (CHD) and CHD related risk factors such as blood pressure (BP), diabetes mellitus (DM) or elevated blood lipid levels. The results however vary with regard to the pattern of hair loss (i.e. moderate, severe, frontal or vertex). Further, no study has investigated for a shared genetic determinant between MPB and CHD as well as CHD related risk factors. Using the longitudinal data from the population-based Heinz Nixdorf Recall study we aimed to systematically investigate the association between MPB and incident CHD and CHD risk factors on (i) an epidemiological (N = 1,673 males) and (ii) a genetic (N = 1,357 males) level. The prevalence of any baldness in our study population was 88% (mean age ± SD: 64±7.5 years). Compared to men with 'no baldness', in men with any kind of baldness a slightly increased risk for CHD (Hazard ratio [95% confidence interval (95%CI)] = 1.2 [0.8; 1.9]), a slightly higher extend of coronary artery calcification (CAC) (Beta [95%CI] = 0.2 [-0.1; 0.6]), a moderately increased risk for DM (prevalence ratio [95%CI] = 1.4 [0.9; 2.0]) and higher body mass index (BMI) (Beta [95%CI] = 0.6 [0.00003; 1.2]) seem to be indicated in the adjusted model. In contrast, the MPB genetic risk score did not show any association with CHD or CHD risk factors. Taken together, the results of our study suggest a weak association between MPB and a few CHD risk factors (CAC, DM and BMI) but do not point to MPB as a strong surrogate measure for CHD and CHD risk factors in general.

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Conflict of interest statement

Funding from Imatron Inc., South San Francisco, CA and Sarstedt AG & Co., Nümbrecht, Germany, did not alter our adherence to PLOS ONE policies on sharing data and materials.

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