REVIEW article
Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders: Autoinflammatory Disorders
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1643709
Association Between Alopecia Areata and Cardiovascular Disease: A Systematic Review and Meta-Analysis
Provisionally accepted
- First Affiliated Hospital, Nanjing Medical University, Nanjing, China
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Background: Alopecia areata (AA) is a common autoimmune disorder causing patchy hair loss. Epidemiological observations and molecular studies collectively suggest an underrecognized interplay between AA and cardiovascular disease (CVD). However, the relationship between them remains controversial and requires further investigation. Objective: To evaluate the association between AA and CVD through a meta-analysis of combinable results. Methods: We systematically searched four databases (MEDLINE, Embase, Web of Science, and Cochrane Library) for relevant studies from inception to December 6, 2024. Studies included in the analysis were cohort or case-control studies that focused on the relationship between AA and CVD. Two independent reviewers extracted the data. The study quality was evaluated using the Newcastle-Ottawa Scale. A random-effects model was used for meta-analysis to calculate the odds ratio (OR) and 95% confidence intervals (CIs). Results: Our search yielded five studies involving 238,270 AA patients from three countries. The meta-analysis revealed that AA patients had an increased OR (OR = 1.71; 95% CI: 1.0 to 2.92; p < 0.01) for CVD outcomes compared to the control group. Subgroup analysis revealed a stronger risk in patients with alopecia totalis or alopecia universalis (OR = 3.80; 95% CI: 1.65 to 8.73; p < 0.01). Associations were not observed between patch-type AA and CVD, nor between AA and ischemic stroke or myocardial infarction. Conclusions: This meta-analysis suggests that AA patients, especially those with alopecia totalis or alopecia universalis, may have an elevated risk of developing CVD. Given the shared immunological mechanisms, systemic inflammation in AA may contribute to the development of atherosclerosis and increased cardiovascular risk. Further studies are needed to validate these findings and clarify the underlying mechanisms.
Keywords: Alopecia Areata, cardiovascular disease risk, cytokine, Systematic review, Inflammation
Received: 09 Jun 2025; Accepted: 22 Jul 2025.
Copyright: © 2025 Lu, Cao, Feng, Yu and Lu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yan Lu, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.