A new wrinkle in cardiac research

August 28, 2018

Nobody likes wrinkles—unless they are on a Pug dog or a Sphinx cat. And even those breeds give some people the willies. But now, researchers have given us another reason to dislike these inevitable signs of aging: If they appear in certain places, they may portend health problems.

First it was earlobe creases that predicted heart disease, according to a 1973 letter published by the New England Journal of Medicine—and proven several times over by researchers. Now it’s a wrinkled forehead, based on a study conducted by Toulouse University Hospital in France.

Indeed, the European Society of Cardiology released results on August 26 of a study by Toulouse University Hospital clinicians that show that . “people who have lots of deep forehead wrinkles—more than is typical for their age may have a higher risk of dying of cardiovascular disease (CVD).”

And those risks are ten times higher than for people with smooth foreheads. The study has found that assessing brow wrinkles could be an easy, low-cost way [of identifying] people who are at high risk for a cardiac disease.

“You can’t see or feel risk factors like high cholesterol or hypertension,” says study author Yolande Esquirol, associate professor of Occupational Health at the Centre Hospitalier Universitaire de Toulouse in France.  “We explored forehead wrinkles as a marker because it’s so simple and visual. Just looking at a person’s face could sound an alarm; then we could give advice to lower risk …. The challenge is in identifying high-risk patients early enough to make a difference.”

According to the study authors, previous research has analyzed different visible signs of ageing to see if they can presage cardiovascular disease. In prior studies, crow’s feet showed no relationship with cardiovascular risk but these tiny wrinkles near the eyes are a consequence not just of age but also of facial movement. A link has been detected between male-pattern baldness, earlobe creases, xanthelasma (pockets of cholesterol under the skin) and a higher risk of heart disease, but not with an increased risk of actually dying.

The authors of the current study investigated a different visible marker of age—horizontal forehead wrinkles—to see if they had any value in assessing cardiovascular risk in a group of 3,200 working adults.  Participants, who were all healthy and were aged 32, 42, 52 and 62 at the beginning of the study, were examined by physicians who assigned scores depending on the number and depth of wrinkles on their foreheads. A score of zero meant no wrinkles while a score of three meant “numerous deep wrinkles.”

The study participants were followed for 20 years, during which time 233 died of various causes.  Of these, 15.2% had score two and three wrinkles; 6.6% had score one wrinkles; and 2.1% had no wrinkles.

The authors found that people with wrinkle score of one had a slightly higher risk of dying of cardiovascular disease than people with no wrinkles. Those who had wrinkle scores of two and three had almost 10 times the risk of dying compared with people who had wrinkle scores of zero, after adjustments for age, gender, education, smoking status, blood pressure, heart rate, diabetes and lipid levels,

“The higher your wrinkle score, the more your cardiovascular mortality risk increases,” explains Dr Esquirol.

Furrows in your brow are not a better method of evaluating cardiovascular risk than existing methods, such as blood pressure and lipid profiles, but they could raise a red flag earlier, at a simple glance.

The researchers don’t yet know the reason for the relationship, which persisted even when factors like job strain were taken into account, but theorize that it could have to do with atherosclerosis, or hardening of the arteries due to plaque build-up. Atherosclerosis is a major contributor to heart attacks and other cardiovascular events.

The study was presented on August 26 at the European Society of Cardiology Congress

Research contact: @cliniquepasteur

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