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Bald & Sexy or Bald & Deadly?

Posted Apr 11 2013 3:00am
When you picture a bald guy, do you envision a sexy Telly Savalas saying his famous, Who loves ya, Baby? Or perhaps someone trying to hide his balding pate with a combover a la The Donald ?  While it's difficult to imagine some men with hair, like former Chicago Bulls, Michael Jordan , many less prominent men keep hair transplant surgeons in business by attempting to replace what's been lost.

I wanted to point this out because a meta-analysis was published earlier this month in BMJ Open in which the authors concluded that vertex baldness was associated with coronary heart disease while frontal baldness was not.  To arrive at their conclusion, the authors analyzed 36,690 participants in 6 observational studies, 3 of which were cohort studies and 3 of which were case-control studies.  Of note, both vertex balding & frontal balding are characteristic of male pattern balding which is thought to be dependent upon both androgens, especially dihydrotestosterone, and genetics.  Therefore, why the difference in linkage?

More importantly, what does this study mean for you & me?  First, we're still not clear as to the rationale behind this association.  Yes, dihydrotestosterone appears to play a role but it's not the complete answer.  Perhaps insulin sensitivity is an issue?  High cholesterol?  High blood pressure?  Second, while we've demonstrated an association, we haven't demonstrated cause & effect.  In fact, we haven't demonstrated that giving someone back his hair reduces the risk of heart disease.  Which means, if you're going to go under the knife, do it because it matters to you, not because you think it might lower your risk for heart disease (which it won't do).

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