A high hair whitening score was associated with increased risk of coronary artery disease, independent of chronological age and established cardiovascular risk factors, found a University of Cairo study.
"Ageing is an unavoidable coronary risk factor and is associated with dermatological signs that could signal increased risk," said Dr Irini Samuel, a cardiologist at Cairo University, Kasr Al-Ainy Hospital, faculty of medicine, department of cardiology, Cairo, Egypt. "More research is needed on cutaneous signs of risk that would enable us to intervene earlier in the cardiovascular disease process."
Atherosclerosis and hair greying share similar mechanisms such as impaired DNA repair, oxidative stress, inflammation, hormonal changes and senescence of functional cells. This study assessed the prevalence of grey hair in patients with coronary artery disease and whether it was an independent risk marker of disease.
This was a prospective, observational study which included 545 adult men who underwent multi-slice computed tomography (CT) coronary angiography for suspected coronary artery disease. Patients were divided into subgroups according to the presence or absence of coronary artery disease, and the amount of grey/white hair.
The amount of grey hair was graded using the hair whitening score: 1 = pure black hair, 2 = black more than white, 3 = black equals white, 4 = white more than black, and 5 = pure white. Each patients' grade was determined by two independent observers.
Data was collected on traditional cardiovascular risk factors including hypertension, diabetes, smoking, dyslipidaemia, and family history of coronary artery disease.
The researchers found that a high hair whitening score (grade 3 or more) was associated with increased risk of coronary artery disease independent of chronological age and established cardiovascular risk factors. Patients with coronary artery disease had a statistically significant higher hair whitening score and higher coronary artery calcification than those without coronary artery disease.
In multivariate regression analysis, age, hair whitening score, hypertension and dyslipidaemia were independent predictors of the presence of atherosclerotic coronary artery disease. Only age was an independent predictor of hair whitening.
"Atherosclerosis and hair greying occur through similar biological pathways and the incidence of both increases with age," said Samuel. "Our findings suggest that, irrespective of chronological age, hair greying indicates biological age and could be a warning sign of increased cardiovascular risk."
Samuel said asymptomatic patients at high risk of coronary artery disease should have regular check-ups to avoid early cardiac events by initiating preventive therapy.
"Further research is needed, in co-ordination with dermatologists, to learn more about the causative genetic and possible avoidable environmental factors that determine hair whitening," she added. "A larger study including men and women is required to confirm the association between hair greying and cardiovascular disease in patients without other known cardiovascular risk factors."
She concluded: "If our findings are confirmed, standardisation of the scoring system for evaluation of hair greying could be used as a predictor for coronary artery disease."
Abstract
Background: Cardiovascular disease is a leading cause of death worldwide. Aging is an unavoidable coronary risk factor and is associated with dermatological signs that could be a marker for increase coronary risk. We tested the hypothesis that hair graying as a visible marker of aging is associated with risk of coronary artery disease independent of chronological age
Method: This prospective observation study included 545 adult males who underwent a multi-slice computed tomography coronary angiography (MSCT CA) for suspicion of coronary artery disease (CAD), patients were divided into different subgroups according to the percentage of gray/white hairs (Hair Whitening Score, HWS: 1-5) and to absence or presence of CAD
Results: CAD was prevalent in 80% of our studied population, (46.8 %) had three vessels disease with mean age of 53.2 ± 10.7 yrs. Hypertension, diabetes and dyslipidemia were more prevalent in CAD group (P=0.001, P=0.001, and P=0.003 respectively). Patients with CAD had statistically significant higher HWS (3 or more, predominately white hair), (32.1 % Vs 60.1 %, p < 0.001) and significant coronary artery calcification (<0.001). Multivariate regression analysis showed that age (OR: 2.40, 95% CI: [1.31-4.39], p= 0.004), Hair Whitening Score (OR: 1.31, 95% CI: [1.09-1.57], p= 0.004), hypertension (OR: 1.63, 95% CI: [1.03-2.58], p=0.036), and dyslipidemia (OR: 1.61, 95% CI: [1.02-2.54], p=0.038) were independent predictors of presence of atherosclerotic CAD and only age (p < 0.001) was found as independent predictor of hair graying.
Conclusion: In our population, high hair whitening score was associated with increased risk of CAD independent of chronological age and other established cardiovascular risk factors
Authors
AMR Elfaramawy, Irini Samuel, Reham Darweesh, Ahmed Shehata, Heba Farouk, Hossam Kandil
[link url="https://www.sciencedaily.com/releases/2017/04/170408104609.htm"]European Society of Cardiology material[/link]
[link url="http://spo.escardio.org/SessionDetails.aspx?eevtid=1245&sessId=21097&subSessId=5916&searchQuery=%2fdefault.aspx%3feevtid%3d1245%26days%3d%26topics%3d%26types%3d%26rooms%3d%26freetext%3dhair%2bgraying%26sort%3d1%26page%3d1%26showResults%3dTrue%26nbPerPage%253#.WOs-RKKxXIU"]EuroPrevent 2017 abstract[/link]