Patients with alopecia areata (AA) may have an increased risk of endothelial dysfunction and subsequent cardiovascular complications. A case-control study found that patients with AA had lower reactive hyperemia index (RHI) scores than patients without AA, indicating the potential need for routine cardiovascular screening in patients with AA.
As a chronic autoimmune disease, alopecia areata causes temporary or permanent hair loss. Previous research suggests that patients with AA have an increased risk of cardiovascular complications, including high blood pressure, high cholesterol, and stroke. In a new study published in Clinical and Experimental Dermatology, researchers suggest that systemic immune activation in patients with AA may contribute to the development of endothelial dysfunction, a marker for atherosclerosis.
The case-control study compared the endothelial function of 52 patients with AA, aged 30–52 years and without a previous cardiovascular diagnosis, to 34 matched controls without AA. Researchers defined endothelial dysfunction as a reactive hyperemia index (RHI) score ≤ 1.67. They also measured arterial stiffness in both groups using the augmentation index (AI@75 beats/min). The Endo-PAT 2000 device was used to measure RHI and AI@75 values.
A total of 42% of the patients with AA and 12% of the healthy controls were found to have endothelial dysfunction. The average RHI score was lower in patients with AA than in healthy controls. However, there were no significant differences in AI@75 between both groups. In addition, RHI scores did not correlate with the severity of hair loss. In other words, there were no significant differences in RHI between patients with progressive, stable, and remitting alopecia.
RHI scores indicate changes in peripheral arterial tone, and lower RHI scores are considered a risk factor for cardiovascular morbidity and mortality. As patients with AA may show more endothelial dysfunction than patients without AA, clinicians may want to implement cardiovascular screening in patients with AA. Screening for cardiovascular disease may allow clinicians to identify and diagnose cardiovascular complications early.
Source:
Waśkiel-Burnat, A., Kotowska, M., Dorobek, W., Smyk, J. M., Gąsecka, A., Niemczyk, A., Blicharz, L., Filipiak, K. J., Olszewska, M., & Rudnicka, L. (2022). Patients with alopecia areata are at risk of endothelial dysfunction: results of a case-control study. Clin Exp Dermatol, 47(8), 1517-1522. https://doi.org/10.1111/ced.15206
