Men who are losing their hair may have bigger worries than just their appearance. Baldness can raise a man’s risk of having a heart attack, a new study suggests.

And the more hair a man has lost, the greater the risk to his heart, according to the study published in the online journal BMJ Open.

Japanese researchers found that men who suffered hair loss from both the front and the crowns of their heads had a 69 percent higher risk of a non-fatal heart attack compared to those with a full head of hair.

Men who had just crown-top hair loss, or vertex baldness, were 52 percent more likely to have a heart attack compared to those with luxurious locks. While the researchers found a 22 percent higher risk in men with receding hairlines, but no other hair loss, that result wasn’t statistically significant.

The findings suggest that men who are losing their hair should head over to the doctor’s office and get a check-up, concluded the research team, led by Dr. Tomohide Yamada, a researcher in the department of diabetes and metabolic diseases in the graduate school of medicine at the University of Tokyo.

Cardiovascular risk factors should be reviewed carefully in men with vertex baldness, especially younger men, and they probably should be encouraged to improve their cardiovascular risk profile, Yamada said.

“We recommend adapting a heart-healthy lifestyle that includes a low fat diet, exercise and less stress [since] classical coronary risk factors such as age, hypertension, dislipidaemia and smoking might influence both conditions,” he said.

The new findings weren’t a complete surprise to 59-year-old Jerry Blum. But he wishes that the study had come out years earlier.

Both Blum and his brother started balding in their 20s. By their 40s, both had developed clogged arteries and heart problems. Now each has been given a stent, a mesh tube designed to keep arteries open.

“When I was 21 and losing my hair I thought, ‘Oh my God, this is the end of the world,’” Blum told Dr. Nancy Snyderman, chief medical editor for NBC News. “Little did I know that it had become an indicator for my heart health. Had I known then what I know now I probably would have been more vigilant.”

To take a closer look at any possible connections between baldness and heart disease, Yamada and his colleagues pored through the medical literature searching for studies on hair loss and cardiovascular disease. The researchers found six large studies and pooled the data to come up with a bigger study, known as a meta-analysis, that included a total of 36,990 men.

The study found not only an increased risk of heart disease in older men, but also in men younger than 60. Among those men, baldness raised the risk of heart attack by a full 44 percent.

Currently no one — including the study’s authors — understands what baldness and heart disease have in common.

But if you think that treating the baldness might help protect the heart, think again, said Dr. Gregg Fonarow, a professor of cardiovascular medicine at the University of California, Los Angeles. “Whether you wear a toupee or use minoxidil, it’s not going to lower your heart disease risk,” Fonarow said. “The real issue is not baldness having a direct effect on the heart, but that it’s a warning of possible heart disease”

Fonarow encourages men to view baldness as a risk factor, just like family history of heart disease or high blood pressure. And that means concentrating on a heart healthy lifestyle, getting plenty of exercise and eating a healthy diet, for example.

Dr. George Cotsarelis, a hair loss expert, suspects that the study might prompt more research into the mechanisms that drive balding.

“There are some really interesting questions here,” said Cotsarelis, a professor and chair of dermatology at the Perelman School of Medicine at the University of Pennsylvania. “There are some biological lessons we might learn from studying male pattern baldness.

“Just last month there was a study showing that African American men with male pattern baldness are more likely to get prostate cancer. This really suggests that something similar is going on in these different tissues. By studying male pattern baldness we might make inroads to lots of different diseases.”

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