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Androgenic alopecia, premature graying, and hair thinning as independent predictors of coronary artery disease in young Asian males

Sharma, Kamala; Humane, Dhammdeepa; Shah, Komalb; Patil, Sachina; Charaniya, Riyaza; Meniya, Jayesha

doi: 10.1097/XCE.0000000000000136
Original articles

Introduction We herewith aimed to explore the association of premature graying, androgenic alopecia (AGA), and hair thinning with coronary artery disease (CAD) in young (≤40 years) male individuals from Western India.

Patients and methods In this prospective, case–control study, 1380 male individuals from a super speciality cardiac care center were enrolled, of which 468 were established cases of CAD and 912 were age-matched healthy male individuals not having history of any major illness including CAD. Details of demographics, cardiovascular risk factors, and cutaneous markers were collected for both the groups.

Results Prevalence of hypertension (30.3 vs. 13.6%), obesity (28.8 vs. 12.2%), hair thinning (36.3 vs. 14.6%), premature graying (49.6 vs. 29.9%), AGA (49.1 vs. 27.4%), and lipid abnormalities (total cholesterol – 16.7 vs. 8.8%; low-density lipoprotein – 7.3 vs. 2.2%; and high-density lipoprotein – 92.5 vs. 88.7%) were higher in cases as compared with control. Multiple logistic regression analysis showed that AGA [5.619, 95% confidence interval (CI): 4.025–7.845, P<0.0001] is the strongest predictor of CAD among young Asian male individuals, closely followed by premature graying (5.267, 95% CI: 3.716–7.466, P<0.0001), obesity (4.133, 95% CI: 2.839–6.018, P<0.0001), and hair thinning (3.36, 95% CI: 2.452–4.621, P<0.0001). SYNTAX score, left ventricle ejection fraction, and degree of disease severity were also found to be independent associates of premature graying and AGA.

Conclusion Our findings support the hypothesis that cutaneous markers are independently associated with underlying CAD irrespective of other classical cardiovascular risk factors. This, in combination with classical markers, could be effectively used for early identification and risk stratification of young patients with occult or established CAD.

aDepartment of Cardiology

bDepartment of Research, U.N. Mehta Institute of Cardiology and Research Centre, Ahmedabad, Gujarat, India

Correspondence to Dr. Kamal Sharma, Department of Cardiology, U.N. Mehta Institute of Cardiology and Research Centre, New Civil Hospital Campus, Asarwa, Ahmedabad 380016, Gujarat, India Tel: +90 995 5119/+91 079 22683978; e-mail:

Received August 16, 2017

Accepted October 11, 2017

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.