Researchers in India say hair patterns like baldness are linked to a fivefold increase in heart disease in younger men. This could apply to women, too.

I’m not proud of this, but when I was in the second grade, I broke my “engagement” to my classmate Matthew when I learned his father was bald.

In my defense, I’ll note that 7-year-olds aren’t particularly knowledgeable about genetics or male pattern baldness.

But perhaps today’s youngsters should pay a little closer attention.

Baldness has now been linked with a fivefold increase in heart disease in young men.

That’s according to research recently presented at the 69th annual conference of the Cardiological Society of India (CSI).

The researchers there noted that obesity, by contrast, is linked with a fourfold risk of early heart disease.

Dr. Kamal Sharma, principal and chief investigator for the study, explained the project in an interview with Healthline.

“This study was designed to look for baldness in patients presenting for heart disease and graded their severity of baldness, graying of hair, and thinness of hair, and correlated it with severity and complexity of heart disease,” he said.

Sharma said the research also answered the chicken-and-egg question of which came first.

“At the time of the heart event, baldness was already present. Hence you can infer that baldness preceded a cardiac event,” he said.

Sharma, associate professor in the department of cardiology at the U.N. Mehta Institute of Cardiology and Research Centre, also noted, “Baldness and premature graying should be considered risk factors for coronary artery disease. These factors may indicate biological — rather than chronological — age, which may be important in determining total cardiovascular risk.”

The study looked for links between premature hair graying and alopecia patterns in young Indian men with coronary artery disease. Alopecia is an autoimmune disease that causes hair to fall out in small, random patches.

The study included 790 men under 40 years old who have coronary artery disease and 1,270 age-matched healthy men who acted as a control group.

All participants had a clinical history taken as well as an electrocardiogram, echocardiography, blood tests, and coronary angiogram.

They were also evaluated for a male pattern baldness score of 0 (none), 1 (mild), 2 (moderate), or 3 (severe), after analysis of 24 different views of the scalp.

A hair-whitening score was determined according to the percentage of gray and white hairs:

  • 1: pure black
  • 2: black greater than white
  • 3: black equals white
  • 4: white greater than black
  • 5: pure white

When all the numbers were crunched, the researchers looked for links between the prematurely gray hair and alopecia lesions. The complexity and severity of those lesions indicated coronary involvement.

The results: The grayer the hair, the greater the incidence of coronary artery disease. It was 50 percent vs. 30 percent in the control group.

After adjusting for age and other cardiovascular risk factors, male pattern baldness showed a 5.6 times greater risk of coronary artery disease. Premature graying was associated with a 5.3 times greater risk.

Male pattern baldness and premature graying were the strongest predictors of coronary artery disease in young Indian men. Obesity followed, which was associated with a 4.1 times greater risk.

Predictors of coronary artery disease also included:

  • diabetes mellitus
  • hypertension
  • family history of premature coronary artery disease
  • central obesity
  • higher body mass index
  • dyslipidemia (high cholesterol)
  • smoking

But these were to a lesser extent than male pattern baldness, premature graying, and obesity.

Although this study was limited to Indian men, Sharma believes it has wider implications.

“Similar studies and few meta-analysis across the ethnicity have shown higher association with balding and graying of hair,” he said. “Though the data is from Asian Indians, we have no reason to believe that biological aging reflected in hair changes would not be associated with heart disease.”

Sharma thinks the research might apply to women as well.

“Biological aging affects women too, but hair growth is also governed by hormonal milieu, too,” he explained. “This study didn’t look into women’s hair patterns, but new studies can look into those aspects as well.”

In fact, he says there are plenty of options for future study.

“Looking for hormonal and genetic linkages apart from biological aging and patterns of cell apoptosis may define and explain how biological aging differs from person to person,” he said. “Future studies should look into these patterns beyond testosterone levels into mechanisms and genetics of hair and heart aging and its linkages — if any.”

Sharma’s fellow researchers offered additional insight into the significance of the study.

Dr. Marco Roffi, course director of the European Society of Cardiology program at CSI and head of the interventional cardiology unit at Geneva University Hospital in Switzerland, said, “Assessment of risk factors is critical in the prevention and management of cardiovascular disease.”

“Classical risk factors such as diabetes, family history of coronary disease, smoking, sedentary lifestyle, high cholesterol levels, and high blood pressure are responsible for the vast majority of cardiovascular disease. It remains to be determined whether potential new risk factors, like the ones described, may improve cardiovascular risk assessment,” he continued.

For the time being, it seems that what’s bad for the scalp may also be bad for the coronary arteries.