Cardiovascular Risk in Patients With Scarring and Nonscarring Alopecias: Assessing the Current State of Evidence

The document reviews the cardiovascular (CV) risk in patients with androgenic alopecia (AGA) and alopecia areata (AA), the two most common non-scarring alopecias. AGA, affecting over 50% of men and women, is linked to CV risk factors like hypertension, dyslipidemia, insulin resistance, and coronary artery disease (CAD). A meta-analysis of 19 studies with 2500 patients showed elevated cholesterol, triglycerides, and low-density lipoprotein levels in AGA patients. A 5-year study with 7000 participants in Taiwan associated moderate or severe AGA with increased mortality risk from diabetes and heart disease. AA, an inflammatory form of nonscarring alopecia, has also been linked to CV risk. A study with over 33,000 AA patients found higher odds of hypertension, hyperlipidemia, diabetes, CAD, and stroke. However, some studies reported a decreased or non-significant CV disease risk in AA patients. The document also discusses CV risks in Lichen Planopilaris (LPP), Frontal Fibrosing Alopecia (FFA), and Central Centrifugal Cicatricial Alopecia (CCCA). Inconsistent associations were found between LPP and hyperlipidemia, hypertension, diabetes, and heart disease. No significant differences were found between FFA patients and controls, while nonobese women with CCCA were four times as likely to have type 2 diabetes. More research is needed to understand the association between these types of alopecia and CV risk, and the impact of alopecia treatment on CV morbidity and mortality.