Researchers said male pattern baldness is linked to an increased risk of coronary heart disease, but only if it's on the top or crown of the head, rather than at the front.
However, a receding hairline is not linked to an increased risk, finds an analysis of published in the British Medical Journal (BMJ).
The researchers trawled the Medline and the Cochrane Library databases and came up with 850 possible studies, published between 1950 and 2012.
Analysis of the findings from these showed that men who had lost most of their hair were a third more likely (32 per cent) to develop coronary artery disease than their peers who retained a full head of hair.
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When the analysis was confined to men under the age of 55-60, a similar pattern emerged. Bald or extensively balding men were 44 per cent more likely to develop coronary artery disease.
Analysis of the other three studies, which compared the heart health of those who were bald/balding with those who were not, painted a similar picture.
Three studies assessed the degree of baldness using a validated scale. Analysis of these results indicated that the risk of coronary artery disease depended on baldness severity, but only if this was on the top or crown of the head.
Extensive vertex baldness boosted the risk by 48 per cent, moderate vertex baldness by 36 per cent, and mild vertex baldness by 18 per cent. By contrast, a receding hairline made very little difference to risk, the analysis showed.
Explanations for the reasons behind the association vary, but include the possibility that baldness may indicate insulin resistance, a precursor to diabetes, a state of chronic inflammation or increased sensitivity to testosterone, all of which are involved directly or indirectly in promoting cardiovascular disease, said the researchers.
"Thus, cardiovascular risk factors should be reviewed carefully in men with vertex baldness, especially younger men" who should "probably be encouraged to improve their cardiovascular risk profile," they said.