Patients with Alopecia Areata are at Risk For Heart Disease

Accumulating data in the past few years is teaching is that patients with several hair loss conditions may be at increased risk for cardiovascular disease. Certainly this seems to be the case for patients with alopecia areata, lichen planopilaris and androgenetic alopecia.

Conic and colleagues 2021 Study

A landmark study in 2021 is really important for us all to know. The study, published in the Journal of the European Academy of Dermatology and Venereology by Conic and colleagues, showed that patients with alopecia areata are at increased risk of certain cardiac and metabolic issues.

The study involved extraction of data from a large electronic database (the Explorys electronic aggregate database), which houses medical records data from more than 50 million patients across the United States. The researchers compared a group of patients with alopecia areata (n=33,130) to a group without AA (n=57,246,350).

Compared with control patients, patients with AA had elevated prevalence rates of several conditions including hypertension, diabetes, hyperlipidemia, coronary artery disease, atrial fibrillation and stroke.

Increased odds for metabolic disorders, coronary artery disease, atrial fibrillation and stroke.

In regression models, patients with AA had significantly increased odds for metabolic disorders, coronary artery disease, atrial fibrillation and stroke. The odds of myocardial infarction (heart attacks) was not significantly elevated in patients compared with control patients (OR, 1.04; 95% CI, 0.97-1.12)

The following table summarizes the magnitude of increased risk in alopecia areata patients compared to controls.

Summary

This is an important study and one of the largest studies to date examining the relationship between alopecia areata and cardiovascular disease. The evidence suggests that patients with alopecia areata are at increased risk for a variety of medical issues including hyperlipidemia, obesity, diabetes, coronary artery disease, atrial fibrillation and stroke.

The study was not designed to allow further investigation into these risks according to subtype of AA or AA severity so we can’t conclude from this particular study if risks are different in alopecia universalis compared to patchy alopecia areata. However, more recent studies have suggested that patients with alopecia totalis and universalis may have higher risks than those with patchy alopecia areata.

Further research may provide insight into how best to reduce this risk in certain patient subgroups.

REFERENCE

Conic RRZ et al. Prevalence of cardiac and metabolic diseases among patients with alopecia areata. JEADV 2021 Feb.