Thinning on top? It could be high blood pressure


Life for balding men really is unfair, it seems.

Not only do they have to come to terms with their hair loss, but now new research suggests that they’re much more likely to suffer from heart disease.

Researchers in Japan have found that men going bald on the crown of the head were 52 per cent more likely to have coronary artery disease than those with a full head of hair.

Male hormones seem to be the link between coronary heart disease and baldness - and it's the more 'masculine' men who may suffer most

Male hormones seem to be the link between coronary heart disease and baldness - and it's the more 'masculine' men who may suffer most

Men with the dreaded double whammy of hair loss — a receding hairline and crown baldness (known as severe vertex baldness) — were 69 per cent more likely to suffer from the condition.

Hair loss is a fact of life for most men.

Half have thinning hair by their 50s and 80  per cent have a degree of hair loss by the age of 70.

But should they all be anxiously considering their heart health? The Japanese researchers certainly think so.

‘Cardiovascular risk factors should be assessed carefully in men with vertex baldness and they should be encouraged to improve their cardiovascular risk profile,’ said lead researcher Dr Tomohide Yamada from the University of Tokyo.

His study was prompted by the fact his (balding) grandfathers died of heart disease.

‘We recommend a heart-healthy lifestyle that includes a low-fat diet, exercise and less stress,’ he says.

But how could coronary heart disease be linked to baldness in men?

After all, one relates to the health of your blood vessels, the other to hormones and genes (some evidence suggests that men with certain genetic markers have a 70 per cent increased risk of going bald).

In fact, male hormones seem to be the link — and it’s the more ‘masculine’ men who may suffer most.

Baldness is usually caused when hair follicles, the tiny scalp cavities from which hair grows, become exposed to too much dihydrotestosterone, or DHT.

This chemical is produced in the body by the male hormone testosterone and is important for development.

But if there is too much DHT in the blood, the follicles shrink, so the hair becomes thinner.

One theory is that baldness is caused by poor blood supply to hair follicles, which causes them to die off

One theory is that baldness is caused by poor blood supply to hair follicles, which causes them to die off

But as well as thinning the hair, high testosterone levels might thicken artery walls and increase blood pressure.

Another theory is that baldness is caused by poor blood supply to hair follicles, which causes them to die off.

So baldness could be a symptom of cardiovascular disease.

While scientists don’t yet know what might come first (what you might call the chicken and egghead question), what is clear is that treating baldness will not protect the heart.

‘The real issue is not baldness having a direct effect on the heart, but that it’s a warning of possible heart disease,’ says Dr Gregg Fonarow, a professor of cardiovascular medicine at the University of California, Los Angeles.

In fact, heart disease is not the only condition that may be revealed by men’s hairline.

Hypertension — high blood pressure — affects around 30 per cent of the population, but many people don’t realise they have it, as it rarely has obvious symptoms.

However, researchers have identified a link between hypertension and hair loss.

Scientists are unsure of the reasons behind the connection, but it’s possible that high blood pressure restricts blood supply to the hair roots.

Researchers have also found a link between type 2 diabetes and hair loss.

Diabetes is often linked to a hardening of the blood vessel walls, leading them to become narrow, according to Dr Erling Thom, a leading pharmacologist.

‘As these vessels become narrower, less oxygen is able to circulate and thereby results in symptoms such as shiny, thickened skin and hair loss,’ he says.

‘Hair loss in this case is not limited to one specific area of the body, as a circulatory impairment in the legs could often result in visible hair loss on the thighs and calves, for example.’

Hair loss can be a symptom of an underactive thyroid, when the thyroid gland doesn’t produce enough of the hormone thyroxine.

Though the condition is often associated with weight gain, it can affect the hair and skin, too.

‘Thyroid hormone speeds up your metabolism, so if you don’t have enough of it the condition of your skin worsens and you get less hair growth,’ says Dr Jan Wadstein, associate professor of medicine at Lund University in Sweden and medical director at Nourkrin.

Hair loss can also be a symptom of the opposite problem, an overactive thyroid, perhaps because this also causes the metabolism to go haywire.

While thyroid problems are most common in women, they can affect men, too.

Your hairline can be affected by medicine — unfortunately, this includes many commonly used prescription drugs, such as those for high blood pressure.

For instance, one Australian study found two types of beta-blockers, metoprolol and propranolol, are linked to hair loss.

Another type of high blood pressure drug, known as angio-tensin-converting enzyme inhibitors, may also trigger thinning hair (possibly by causing the hair to be shed before the end of its natural lifecycle).

So, too, can medicines to lower the risk of blood clots or stroke.

A study from the University of California highlighted a blood-thinning medication called low molecular weight heparin as a cause of hair loss.

Warfarin may also cause similar problems, though this is much  less common.

Some antidepressants can also thin the hair, the Australian study found. These include fluoxetine — better known as Prozac — as well as tricyclic antidepressants.

The good news is that once you stop taking the medication, the hair usually grows back. However, doctors warn you should not stop taking medication without consulting your GP.

‘The loss of a few hairs is trivial compared with the loss of your mental health or the risk of stroke,’ says Sam Shuster, emeritus professor of dermatology at Newcastle University.

But if you’re not taking medication linked to hair loss, what action can a balding man take to protect his heart?

The key message is, don’t panic — because the science behind the latest findings is far from clear.

As Dr Alex Lyon, consultant cardiologist at the Royal Brompton Hospital, explains: ‘There is some evidence that higher testosterone is linked to heart disease, but conversely low levels of testosterone are, too.

‘All you can really do is try to live healthily — exercise, weight loss, a healthy diet and not smoking.

‘Balding or bald men should not be overly worried. I’m starting to thin on top — but I’m not running off to my cardiologist!’

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