ABSTRACT

It has been a debate whether phenotypic features are associated with increased risk of coronary heart disease. Proposed explanations for this relation include biological aging, individual susceptibilities, and androgens which contribute to both the atherosclerotic process and dermatological signs. The results of the studies are inconsistent and most are not based on cardiovascular imaging techniques. Here, association between androphenotypic features and the risk and severity of coronary artery disease (CAD) in men is evaluated.

This case–control study consists of 166 male patients with angiography-proven CAD and 160 age-gender-matched controls. Gensini score of angiograms (for severity of CAD) and phenotypic characteristics including androgenetic alopecia (AGA), thoracic hairiness (TH), hair graying a diagonal earlobe crease (DEC), and hairy ear (HE) were recorded. Men with well-established cardiovascular risk factors were excluded.

AGA, DEC, and HE were significantly more frequent in patients with CAD than controls (98.2% and 83.1% [P < 0.001], 61.4% and 23.8% [P < 0.001], 69.3% and 50.6% [P = 0.001], respectively). As the severity of AGA increased, the incidence of heart disease was increasing in patients. The presence of TH and AGA was found to be related to higher Gensini scores.

The exact mechanism between these phenotypic features and CAD still remains to be elucidated. However, observation of visible aging signs is easy and inexpensive. AGA, HE, and DEC may be used as early screening tools for CAD.