People with Alopecia Areata More Likely to Have a Stroke

A Taiwanese study has found that people with the autoimmune condition Alopecia Areata are more susceptible to stroke.

Although the precise level of risk for people with this common cause of hair loss was not established, a far higher associated risk was established.

First recorded link

Researchers from various Taiwanese medical institutions, led by Jiunn-Horng Kang of the Taipei Medical University Hospital, have published their findings in a report entitled, 'Alopecia Areata Increases the Risk of Stroke: a 3-year Follow-Up Study'. In it they note, 'To the best of our knowledge, there are still no data on the association between AA and stroke', making this the first study of its kind.

The methodology for this large-scale retrospective cohort study involved identifying 3,231 test subjects with Alopecia Areata (AA) who had received health care attention between January 2004 and December 2011, from the Taiwan “Longitudinal Health Insurance Database 2000”. This database information was taken from the Taiwan National Health Insurance (NHI) programme, available to the public via the Taiwan National Health Research Institute, and contains registration files and claims data of 1,000,000 individuals randomly sampled from the 2000 Registry for Beneficiaries of the NHI programme.

All forms of Alopecia Areata, from patchy hair loss of the scalp to Alopecia Totalis and Alopecia Universalis, were considered for the retroactive study and 16,155 'matched patients' were randomly selected as the comparison group. None of the individuals studied had any history of stroke, all were over 18 years of age and none of the control group had a history of AA.

Using the database information, each of the Taiwanese volunteers was individually monitored over a three year period and any diagnoses of stroke during this timeframe were recorded. The results were then compared between those with AA and the control group.

Study findings revealed

In the participants with Alopecia Areata, a stroke incidence rate of 5.44 (95% confidence interval (CI) = 4.03 ~ 7.20) was recorded per 1000 person-years. This dropped to a rate of 2.75 (95% CI = 2.30 ~ 3.27) for the control volunteers without AA. These figures demonstrated that those people with Alopecia Areata were almost twice as likely to have a stroke as those without.

Using the Cox model of proportional hazards - an established mathematical way of defining statistics by relating the time that passes before an event to one or more variants associated with that quantity of time - an adjusted hazard ratio of 1.61 (95% CI = 1.13 ~ 2.30) for stroke in people with AA within the follow-up period compared to the controls was established.

'We concluded that patients with AA were associated with a higher risk of stroke in the 3-year follow-up period in Taiwan,' states the published report. Although the type of stroke each person affected suffered was recorded, the results showed that those with AA consistently demonstrated 'a higher hazard of stroke within the 3-year follow-up period than patients without AA regardless of stroke type'.

Researchers further confirmed that additional studies to corroborate their findings, and to explore the underlying pathomechanism, were needed. Continues below.

Alopecia Areata and Stroke

Little is known about why Alopecia Areata occurs but when it does, it turns the body against its own hair follicles. As a result the follicles suspend normal hair growth and remain dormant in the telogen (resting) phase, awaiting the signal to recommence their regular cycle. Attacks can be confined to areas on the scalp that measure around the size of a 50 pence piece, or can affect the whole head, or indeed the whole body from head to toe causing complete hair loss.

Whilst in many cases the hair will regrow naturally - although the condition may recur again later - there are also effective Alopecia Areata treatment options available for the mild-to-moderate form of the condition. High strength minoxidil, applied topically, has been shown to produce significant regrowth in many Belgravia clients. As yet, despite the promising clinical trials taking place into JAK inhibitors, there are still no promising treatments for the more severe forms of AA, such as Alopecia Totalis and Universalis.

In June 2015, ground-breaking findings from a study at the University of Virginia (UVA) School of Medicine showed that the brain is in fact directly linked to the autoimmune system. This significant discovery was thought to prove radical in understanding how autoimmune disorders work and the pathways they follow - essential information when looking to find a treatment or cure.

Given a stroke is a neurological disease, often linked to cardiovascular issues, depression and inflammation, these two schools of research may go hand-in-hand in providing helpful insight into these links between the two conditions. Hopefully this could lead, not only to a better understanding of why any links exist but also to compelling treatments for both.

"These findings may help in the development or prevention of the condition or the correlated disease such as stroke, either way, it can only be useful,"says Belgravia Hair Loss Specialist, Leonora Doclis. "Diabetes and Rheumatoid Arthritis, both autoimmune diseases like Alopecia Areata also have a link to stroke. The stress and shock that a person with Alopecia Areata goes through are contributory factors to stroke. Whether one condition  leads to another or contributes to the other is unknown but hopefully this study can lead to more research in future."