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the observed correlation between baldness and heart disease demonstrates that

Govind  KLShort Carey Received for publication March 15, 2002; accepted for publication August 28, 2002. A direct association between testosterone and heart disease has never been established, but for many years, doctors have suspected that a link exists.  HC  AMorinelli This study was supported by grants HL26490, HL34595, CA34944, and CA40360 from the National Institutes of Health, Bethesda, Md. Karter While early studies of baldness and CHD were limited by small sample size,1-4 our findings agree with results from recent large epidemiologic studies.5,6,8 In the case-control study of 1432 men aged 21 to 54 years (665 cases of first MI and 772 controls), men with severe vertex baldness had a 3-fold higher risk of MI when compared with those with no hair loss.7 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. In a systematic review of observational studies of anabolic steroid use, androgen administration was associated with lower levels of high-density lipoprotein (HDL) cholesterol and higher total-HDL cholesterol ratios.28 Induction of experimental hypogonadism with a gonadotropin-releasing hormone antagonist (Nal-Glu) for 6 weeks increased HDL levels by 26% and total cholesterol levels by 12% among healthy young men. During 11 years of follow-up, the study participants experienced 1446 CHD events.  PV Testosterone increases human platelet thromboxane A2 receptor density and aggregation responses. Paulo A. Lotufo, MD, is recipient of fellowship 97-02424-8 from the Fundação de Amparo a Pesquisa de Estado de São Paulo, São Paulo, Brazil. After controlling for age and treatment assignment, MPB was associated with a modest increase in risk of CHD events (Table 2). EPIDEMIOLOGIC studies examining male pattern baldness (MPB) and coronary heart disease (CHD) have tended to support a positive association. A more likely explanation for the association between baldness and heart disease is that both conditions are affected by an underlying factor.  JEManson Describe in economics there are few absolute solutions. Men with severe baldness seem to have a greater number of androgen receptors in the scalp16 and higher levels of both serum total and free testosterone.17 In a recent trial with finasteride,18 a drug that inhibits the conversion of testosterone to dihydrotestosterone in scalp and other tissue by blocking the 5α reductase enzyme, arrest of hair loss and substantial hair regrowth were noted among men receiving the agent. There is growing evidence that indicates an association between male-type baldness and coronary artery disease (CAD) 5. Making choices that are expected to achieve the highest possible value for some objective is termed: The economic way of thinking has to do with: The BEST example of making a choice at the margin is: C) a coffee drinker drinking another cup of coffee.  HIto The observed association was independent of age and was stronger in a subgroup of men with hypertension or high cholesterol. The current rate of unemployment is 5 percent. The observed correlation between baldness and heart disease demonstrates that: D) there is probably some other factor that causes both baldness and heart disease.  GA Ischemic heart disease and stroke mortality in African-American, Hispanic, and non-Hispanic white men and women, 1985 to 1991. Our study demonstrates that an aging sign like gray hair in men indicates susceptibility to coronary heart disease with a strength similar to that of smoking and the presence of diabetes mellitus. Aspirin in the primary prevention of angina pectoris in a randomized trial of United States physicians. D) there is probably some other factor that causes both baldness and heart disease. determines: C) how resources are combined in the production of goods. C) bald men are generally unreliable. Coronary heart disease events defined as nonfatal myocardial infarction (MI), angina pectoris, and/or coronary revascularization. Comment on their conclusion that this shows that baldness is not a possible cause of heart disease. Terms of Use| Vertex pattern baldness appears to be a marker for increased risk of CHD events, especially among men with hypertension or high cholesterol levels. Male pattern baldness was first defined as an autosomal dominant trait 80 years ago,31 although recent studies suggest a polygenic mode of inheritance.32 Recent findings suggest genetic similarities between MPB and polycystic ovary syndrome,33,34 a common familial condition in women characterized by elevated levels of androgens.  MFarinaro Hair pattern classification and frequency among participants in the Physicians' Health Study. C) social science concerned chiefly with how people choose among alternatives. Multivariate logistic regression models were used to control for age (1-year categories), aspirin and beta carotene assignment, body mass index (weight in kilograms divided by the square of the height in meters as a continuous variable), height (as a continuous variable), cigarette smoking (never, past, <20 cigarettes per day, ≥20 cigarettes per day), alcohol consumption (daily, weekly, monthly, rarely/never), hypertension (self-reported systolic blood pressure ≥160 mm Hg, diastolic blood pressure ≤95 mm Hg, or taking antihypertensive medication), high serum cholesterol level (self-reported cholesterol level ≥6.47 mmol/L [250 mg/dL] or taking cholesterol-lowering medication), parental history of MI before age 60 years, and frequency of vigorous exercise (0, 1, 2-4, ≥5 times per week).  LShapiro  et al. As a comparison, the Pearson's correlation(r), between …  DSTalbott B) the highest valued other choice that could have been made. Significant between-hospital variation (up to ninefold) in adjusted cost was observed across operations. The previous study found that, compared with men with no hair loss, men with frontal baldness had a 9% increased risk for heart conditions and those with vertex baldness had a 23% increased risk. Sheikh Baldness was assessed in 1956 and 1962 in a cohort of 2017 men observed for 24 years for new CHD events, cardiovascular events, CHD, and all-cause mortality. Ben-Halim 1 - 8 In the Framingham Heart Study, 5 progression of hair loss during adulthood was associated with CHD in men, although there was no relationship with the extent of scalp baldness. Cardiovascular risk factors activate a number o… Conclusion  7. On the 11-year follow-up questionnaire, participants were asked "Which of the following most closely approximates your hair pattern at age 45?" Like other muscles, cardiac cells have receptors that bind male hormones. D) ceteris paribus, which means all other things remain unchanged. Microeconomics deals with: A) the working of the entire economy or large sectors of it.  RBGerstman A plausible explanation for an association between baldness and CHD may be elevated androgen levels. A case-control study comparing the frequency of shaving in … Recall bias is unlikely but cannot be excluded, as physicians may be aware of a possible association between MPB and CHD risk. EPIDEMIOLOGIC studies examining male pattern baldness (MPB) and coronary heart disease (CHD) have tended to support a positive association.1-8 In the Framingham Heart Study,5 progression of hair loss during adulthood was associated with CHD in men, although there was no relationship with the extent of scalp baldness. Participants with no hair loss were less likely to be never-smokers, to have high cholesterol levels, or to report a positive parental history of myocardial infarction. Trevisan They also asked a control group (not suffering from heart disease) of 772 males to do the same baldness assessment.  LR Hair pattern of the scalp of white and Negro males. Between July 1, 1986, and June 30, 1996, the incidence rates of CHD-related events were assessed in the 71 617 women aged 40 to 65 years who answered these questions and were not diagnosed as having cardiovascular disease or cancer in 1986 (the baseline year for these analyses). Hibberts Our data are compatible with these findings for hypertension and high cholesterol levels, but we detected no modifying effect by parental history of MI.  AM The comparative histopathology of male pattern baldness and senescent baldness.  KDOlsen Talbott  JMCohen  DBurton  OT Male pattern baldness: classification and incidence. Ajayi Although the baseline prevalence of these risk factors was only slightly higher in men with hair loss, a possible link between baldness and these risk factors was suggested in the Olivetti Heart Study in Naples, Italy,15 in which 872 men underwent measurements of blood pressure levels, serum cholesterol levels, and direct examinations of the scalp, with hair pattern coded as no hair loss, frontal hair loss, and frontal-occipital hair loss. to download free article PDFs, These lipid alterations are most likely due to decreased androgen levels because they are reversed by administration of the gonadotropin-releasing hormone antagonist together with testosterone.29. In 1979, Cooke studied the prevalence of male pattern alopecia, CAD, hypertension, and smoking habits in 478 male Caucasian hospital inpatients over the age of 20 years. Copenhagen, Denmark Regional Office for Europe, World Health Organization April26-29 1971; Norwood The observed correlation between baldness and heart disease demonstrates that: A) being bald causes a man to have heart disease. The value of the next-best choice not chosen is called opportunity cost. When the end points of nonfatal MI, angina, and coronary revascularization were considered separately, similar results were obtained for each outcome (Table 3). A hypothesis that has been tested extensively without being rejected and has won widespread acceptance is a: A theory that has won virtually universal acceptance is a: A simplified representation of a particular problem is a: A) model. In addition, the location of hair loss (frontal vs vertex) was not assessed, and the study's statistical power was limited. Kaufman  IMorita The situation when we face alternative choices is called abundance.  ESugimoto  JMCarpenter  RN Polycystic ovaries are inherited as an autosomal dominant trait: analysis of 29 polycystic ovary syndrome and 10 control families. Gallant In the First National Health and Nutrition Examination Survey (NHANES I),6 an association was observed between severe baldness and CHD mortality in men younger than 55 years, but not among older men.  JEBuring Pattern hair loss is hair loss that primarily affects the top and front of the scalp. Several potential limitations of our study warrant discussion. D) the value of the best alternative forgone in making any choice. Main Outcome Measures  A validation study confirmed the self-report for 97.8% of the cases of angina, as described elsewhere.9 In 11 years of follow-up, there were 1305 cases of angina, 550 cases of nonfatal MI, and 1089 coronary revascularization procedures. The study of how people choose among the alternatives available to them is the: According to the textbook, economics is a: A) social science that deals with making choices among alternatives. Privacy Policy|  KRuff The existence of alternative uses of a resource implies that it is: The problem of scarcity is confronted by: A(n) _______ does not pose the problem of scarcity; one use of the good is not an alternative to another use. The fundamental economic questions that every economic system must answer are: An answer to the question "How are goods produced?" D) the opportunity cost of that choice is the highest-valued other choice that could have been made. Ford Animals that are given testosterone develop enlarged hearts. An answer to the question "For whom" determines: D) who gets the goods and services produced.  MRBoyer  T Baldness and ischemic heart disease in a national sample of men. The Case in Point on "baldness and heart disease" suggests that by preventing baldness: here is probably some other factor that causes both baldness and heart disease. angioplasty, … C) being bald actually makes heart disease less likely.  R The inheritance of common baldness: two B or not two B?  NAHowell Matsuda Receptors for dihydrotestosterone have been found in mouse and baboon heart muscle and endothelial cells.19,20 In rats, dihydrotestosterone may directly accelerate atherosclerosis by stimulating the proliferation of vascular smooth muscle cells.21 Administration of testosterone was associated with a significant increase in platelet thromboxane A2 receptor density in rodents.22, A similar effect—an increase in platelet aggregation—was observed in young men receiving clinical replacement doses of testosterone following orchiectomy.23 Complete androgen deprivation for 6 months or more after orchiectomy has been associated with improved endothelial function compared with men having normal androgen levels.24 Testosterone exacerbates hypertension in spontaneously hypertensive rats by reducing pressure-natriuresis25 and by increasing levels of 11-deoxycorticosterone through inhibition of 11β-hydroxylase activity.26,27, Androgens also alter lipid profiles. The respondents answered the question, "Which of the following most closely approximates your hair pattern at age 45?"  CH Baseline characteristics of participants in the Physicians' Health Study: a randomized trial of aspirin and beta-carotene in U.S. physicians.  EKrogh In contrast, our data indicate an association between vertex baldness and CHD in young and older men, as well as an association between severity of hair loss and increasing risk of CHD.  WLesko  DW Factors discriminating men with coronary heart disease from healthy controls. A more recent observation in support of this hypothesis was made by a man living on a remote island who found, upon his return to the mainland, that the weight of beard shaved every 24 hours was heavier immediately prior to and during periods of sexual activity (2). Fujimoto Schnohr C) emphasis on how choices are made at the margin.  S Androgen receptors, 5 alpha-reductase activity and androgen-dependent proliferation of vascular smooth muscle cells. Finasteride in the treatment of men with androgenetic alopecia: Finasteride Male Pattern Hair Loss Study Group.  WDMurphy  D Inheritance of baldness. Men who experienced premature greying had a 5.3 times greater risk. Moreover, random misclassification would have led to an underestimate of the magnitude of association between baldness pattern and CHD. The study, involving a random sample of 20,000 men and women in the Copenhagen City Heart Study, recorded the extent of baldness, gray hair, wrinkles and a …  et al.  JESatterfield Our prevalence ratio, considering whether diabetes is a risk factor for coronary heart disease is 12.04 / 3.9 = 3.1.  MJCelermajer The Physicians' Health Study (PHS) of 22,071 apparently healthy men at baseline provided a unique opportunity to evaluate whether different patterns of male baldness at age 45 years were associated with future risk of coronary events, including nonfatal MI, angina, and coronary revascularization. A ‘J curve’ relationship was observed between body mass index (BMI) and risk of HF with maximum risk in the morbidly obese (1.73 (95% CI 1.30 to 2.31), p<0.001, n=11). The correlation between hyperhomocysteinemia and atherosclerotic disease was first proposed more than 40 years ago. To examine the association between male pattern baldness and the risk of coronary heart disease (CHD) events. We detected no effect modification when we performed analyses stratified by age (older and younger than 55 years at baseline). Statements that make value judgments are: B) A high rate of economic growth is good for the country.  JFZhang  D Unadjusted rates of procedural complications or death did not change based on the presence or amount of payments, while there were "statistically significant" differences in use of CRT-D and small differences in use of guideline … The fundamental economic questions that every economic system must answer are: a. what, how, and for whom. These differences may be a result of our larger sample size and the specificity of our measure of baldness (frontal vs vertex). Sheridan Whenever a choice is made: A) the value of all the other choices that could have been made is called opportunity cost. These data from a large retrospective cohort study of US male physicians indicate that MPB is a marker for risk of CHD, with increasing risk associated with hair loss. As life expectancies increase, signs of … In Figure 5, we demonstrate that there is a strong correlation between the baseline explant and autopsy hearts compared to their later timepoints (Pearson's correlation ranges from 0.92-0.98). Compared with men with no hair loss, those with frontal baldness had an age-adjusted relative risk (RR) of CHD of 1.09 (95% confidence interval [CI], 0.94-1.25), while those with mild, moderate, or severe vertex baldness had RRs of 1.23 (95% CI, 1.05-1.43), 1.32 (95% CI, 1.10-1.59), and 1.36 (95% CI, 1.11-1.67), respectively (P for trend, <.001).  AHChan  et al.  CJKnopp  RGEvans By continuing to use our site, or clicking "Continue," you are agreeing to our, 2020 American Medical Association.  S A case-control study of baldness in relation to myocardial infarction in men.  DWilliamson C) an increase in investment spending tends to reduce unemployment. Design, Setting, and Participants  Manson  MR  PJMcGill deals with: D) the kinds and quantities of goods and services produced.  RG Heart contains receptors for dihydrotestosterone but not testosterone: possible role in the sex differential in coronary heart disease. The questions of what goods to produce, how to produce them, and for whom to produce them are of concern only in advanced industrial economies.  WWRivier Serum androgens: associations with prostate cancer risk and hair patterning.  S Evidence for a single gene effect causing polycystic ovaries and male pattern baldness. It was first identified by McCully in 1969.  VA Balding hair follicle dermal papilla cells contain higher levels of androgen receptors than those from non-balding scalps. Customize your JAMA Network experience by selecting one or more topics from the list below.  FWhite  WJ Physiologic testosterone levels in normal men suppress high-density lipoprotein cholesterol levels.  SGNixon The observed correlation between baldness and heart disease demonstrates that: A) there is probably some other factor that causes both baldness and heart disease. Network experience by selecting one or more topics from the list below, heart. 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