Could early balding signal heart trouble in men?

Preliminary research hints -- but cannot prove -- that men who lose their hair relatively early in life might be at heightened heart risk.

The study involved about 2,000 Indian men under 40 years of age. The researchers said that men who went prematurely gray and experienced male-pattern baldness at a young age had greatly increased odds for heart disease.

After adjusting for age and other cardiovascular risk factors, the investigators concluded that male-pattern baldness was associated with a 5.6 times greater risk of developing heart disease, while premature graying was tied to a 5.3 times higher risk.

"Baldness and premature graying should be considered risk factors for coronary artery disease," principal investigator Dr. Kamal Sharma said. He's associate professor of cardiology at the U.N. Mehta Institute of Cardiology and Research Center in Ahmedabad, India.

"These factors may indicate biological -- rather than chronological -- age, which may be important in determining total cardiovascular risk," he explained in a news release from the European Society of Cardiology (ESC).

But cardiologists in the United States believe much more study is needed. They suggested that it's premature for America's prematurely balding and graying men to worry that their pates reflect their heart risk.

Dr. David Friedman is chief of heart failure services at Northwell Health's Long Island Jewish Valley Stream Hospital in Valley Stream, N.Y. Reading over the findings, he noted that the study only focuses on one ethnicity -- South East Asian Indian men. So, much larger studies involving "different patient ethnicities would have to be conducted to help tease out this finding to see if it occurs as a more widespread phenomena."

Dr. Satjit Bhusri, a cardiologist at Lenox Hill Hospital in New York City, was even less convinced. He said that while the study offers a "preliminary association" between early hair loss in men and heart disease, it cannot prove cause and effect.

"It should be reinforced to our balding and premature graying friends that there is no concern when it comes to risk-related heart disease," Bhusri said.

In the study, Sharma's group examined 790 men younger than age 40 with heart disease and 1,270 men in the same age group without heart disease.

Men with heart disease had higher rates of premature graying (50 percent versus 30 percent) and male-pattern baldness (49 percent versus 27 percent) than those without heart disease, the researchers found.

Diabetes, high blood pressure, family history, smoking, belly fat and high body mass index (a measurement based on height and weight) were also predictors of heart disease, but to a lesser extent than male-pattern baldness, premature graying and obesity, the study authors noted.

According to study lead author Dr. Dhammdeep Humane, "Men with premature graying and (male-pattern baldness) should receive extra monitoring for coronary artery disease and advice on lifestyle changes such as healthy diet, exercise, and stress management."

But Humane, senior cardiology resident at the Mehta Institute, agreed with the U.S. doctors that it's far too early to suggest that balding pates or graying hair indicates that a man needs heart medicines.

"Our study found associations, but a causal relationship needs to be established before statins can be recommended for men with baldness or premature graying," Humane said.

In the meantime, Marco Roffi, head of the interventional cardiology unit at Geneva University Hospital in Switzerland, pointed out that men who worry about their heart can take tried-and-true steps to keep it healthy.

"Classical risk factors such as diabetes, family history of coronary disease, smoking, sedentary lifestyle, high cholesterol levels and high blood pressure are responsible for the vast majority of cardiovascular disease," Roffi said in the ESC news release.

The study was scheduled to be presented Thursday at the annual meeting of the Cardiological Society of India. Findings presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.