Do patients with alopecia areata have an increased risk of heart disease - or not ?

A recent study published in the Journal of the European Academy of Dermatology and Venereology in February 2021 showed that patients with alopecia areata are at increased risk of certain cardiac and metabolic issues. A second study by other researchers now suggests the opposite - that patients alopecia areata are not an increased risk for heart disease.

Let’s take a look together at these studies.

Two recent studies appear to conflict with each other. One study suggests patients with alopecia areata may be at increased risk for heart disease and a second suggests this is not the case.

STUDY 1: Conic and Colleagues, 2021

A study by Conic and colleagues 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, and hyperlipidemia. Coronary artery disease, atrial fibrillation and stroke were increased as well.

STUDY 2: Lee and Colleagues, 2021

In a new study, Lee and colleagues performed a retrospective cohort study to evaluate the risk of subsequent heart disease in patients with alopecia areata. The authors reviewed 3770 cases of alopecia areata and from 18,850 age, sex, and income level-matched controls without alopecia areata. The authors found that alopecia areata was not associated with a higher risk of heart failure, angina pectoris, or myocardial infarction. There was no significant increase in the risk of overall heart disease associated with a diagnosis of alopecia areata. In addition, neither the severity nor the duration of having alopecia areata was related to any sort of increased risk for heart disease. The conclusion of this particular study was that alopecia areata does not increase the risk of heart disease.

These two studies appear to conflict with each other. Further discussion and research will be needed to help clarify this important issue.

References

Lee et al. Alopecia areata is not a risk factor for heart diseases: A 10-year retrospective cohort study. PLoS One. 2021.

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