Losing your hair or going grey were both stronger risk factors for heart disease than obesity, according to the study.
Researchers found male-pattern baldness and premature greying are associated with a more than five-fold risk of heart disease before turning 40.
Obesity was associated with a four-fold risk of early heart disease, according to the findings.
Study author Dr Sachin Patil, of the UN Mehta Institute of Cardiology and Research Centre in Ahmedabad, India, said: “The incidence of coronary artery disease in young men is increasing but cannot be explained by traditional risk factors.
“Premature greying and androgenic alopecia – or male-pattern baldness – correlate well with vascular age irrespective of chronological age and are plausible risk factors for coronary artery disease.“
This study investigated the association of premature hair greying and alopecia patterns in young Indian men with coronary artery disease.
The study included 790 men aged under 40 with coronary artery disease and 1 270 age-matched healthy men who acted as a control group.
All the participants had a clinical history taken, and underwent electrocardiogram (ECG), echocardiography, blood tests, and coronary angiogram.
Researchers analysed the link between premature grey hair and alopecia with the complexity and severity of angiographic lesions – an indicator of coronary artery disease – and compared the results between the two groups.
They found that young men with coronary artery disease were more commonly going grey prematurely and were more likely to have male-pattern baldness.
After adjusting for age and other cardiovascular risk factors, male-pattern baldness was associated with a 5.6 times greater risk of coronary artery disease and premature greying was associated with a 5.3 times greater risk.
Male-pattern baldness and premature greying were the strongest predictors of coronary artery disease in young Indian men followed by obesity, which was associated with a 4.1 times greater risk.
Diabetes, high blood pressure, a family history of premature coronary artery disease, central obesity, higher body mass index, dyslipidaemia and smoking were predictors of coronary artery disease but to a lesser extent than male-pattern baldness, premature greying, and obesity.
Principal investigator Dr Kamal Sharma, said: “Baldness and premature greying should be considered risk factors for coronary artery disease.
“These factors may indicate biological, rather than chronological, age which may be important in determining total cardiovascular risk. Currently physicians use common sense to estimate biological age, but a validated scale is needed.“
Lead author Dr Dhammdeep Humane, also of the UN Mehta Institute of Cardiology and Research Centre, added: “Men with premature greying and androgenic alopecia should receive extra monitoring for coronary artery disease and advice on lifestyle changes such as healthy diet, exercise, and stress management.
“Our study found associations but a causal relationship needs to be established before statins can be recommended for men with baldness or premature greying.”
The findings are due to be presented at the Annual Conference of the Cardiological Society of India in Calcutta.
Professor Marco Roffi, head of the Interventional Cardiology Unit at Geneva University Hospital in Switzerland, added: “Assessment of risk factors is critical in the prevention and management of cardiovascular disease.
“Classical risk factors such as diabetes, family history of coronary disease, smoking, sedentary lifestyle, high cholesterol levels and high blood pressure are responsible for the vast majority of cardiovascular disease.
“It remains to be determined whether potential new risk factors, like the ones described, may improve cardiovascular risk assessment.”