The Physicians' Health Study from the Division of Preventive Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital (Drs Lotufo, Chae, Ajani, Hennekens, and Manson), the Cardiology Division, Massachusetts General Hospital and the Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, published in the Archives of Internal Medicine (Vol. 160 No. 2, January 24, 2000) indicates that Male Pattern Baldness (MPB) is a marker for risk of Coronary Heart Disease (CHD).

A retrospective cohort study among 22,071 US male physicians aged 40 to 84 years enrolled in the physicians' Health Study was conducted. Of these, 19,112 were free of CHD at baseline and completed a questionnaire at the 11-year follow up concerning their pattern of hair loss at age 45 years. Response options included no hair loss, frontal baldness only, or frontal baldness with mild, moderate, or severe vertex baldness.

Such study concluded "Vertex pattern baldness appears to be a marker for increased risk of CHD events, especially among men with hypertension or high Cholesterol levels", as it appeared in the Archives of Internal Medicine;..."men with severe vertex baldness had a 3-fold higher risk of MI when compared with those with no hair loss. A subgroup of men with severe vertex baldness and hypertension, high cholesterol levels, or parental history of MI had an even higher risk of MI before age 60 years."

The study indicates that there may be two possible explanations for such link, elevated androgen levels and/or genetic inheritance:
"A plausible explanation for an association between baldness and CHD may be elevated androgen levels. Men with severe baldness seem to have a greater number of androgen receptors in the scalp and higher levels of both serum and total free testosterone... High levels of androgens may directly contribute to both atherosclerosis and thrombosis, and may adversely influence risks factors such as hypertension and high cholesterol."

"One alternative possible link between MPB and CHD could be a similar pattern of inheritance, as others have speculated. Unfortunately, little is known about the genetics of hair loss and baldness. Male pattern baldness was first defined as an autosomal dominant trait 80 years ago, although recent studies suggest a polygenic mode of inheritance. Recent findings suggest genetic similarities between MPB and polycystic ovary syndrome... Other genetic factors may play a role in explaining the association between MPB and CHD risk. However, controlling for parental history of premature coronary disease did not materially alter the association between MPB and CDH risk in our data", the study stated.

"Although early vertex baldness may be a non-modifiable risk factor for CDH, it may serve as a useful clinical marker to identify men at increased risk who may benefit from aggressive screening and primary prevention efforts directed toward other known modifiable risk factors for CHD", was concluded in the Physicians' Health Study.