For years we’ve known about Frank’s sign, an earlobe crease that appears to signify increase heart disease risk. Now a study presented this week at the European Society of Cardiology suggest forehead wrinkles may do the same.
Researchers believe that in atherosclerotic disease, blood flow may be impeded, not only affecting the heart but also the skin, making deep wrinkles more inevitable. Collagen and elastic fibers may also lose their elasticity allowing wrinkles to easily form.
For this study, the authors did the following (according to MedicalXpress):
The authors of the current prospective 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.
Israeli researchers reviewed the records of 241 people who had suffered a stroke and 78.8% of them had Frank’s Sign.
Nazzal et al wrote, “Frank sign could predict ischemic cerebrovascular events. Patients with classical cardiovascular risk factors had Frank sign in a higher frequency.”
In 1973, Dr. Sanders T. Frank first described it in patients with coronary artery disease.
Subsequent studies found a relationship as well to diagonal earlobe crease (DELC) and heart disease. One study even utilized CT angiography to document the relationship, (Shmilovich, et al. .Relation of diagonal ear lobe crease to the presence, extent, and severity of coronary artery disease determined by coronary computed tomography angiography. Am J Cardiol).
If Frank’s sign predicts heart disease, it would make sense that it could also predict stroke risk. The diagonal crease in one’s earlobe may hint to underlying atherosclerosis. The vessel damage and cholesterol plaques can affect blood flow to the brain. Hence, both conditions share similar risks.
The more extensive the crease, the higher the “grade” of the crease where a small wrinkling (Grade 1) is less ominous than a deep crease along the whole earlobe (Grade 3). The image above appears to have both a Grade 1 and Grade 3.
Multiple theories suggest why deep wrinkles and earlobe creases suggest heart disease or stroke risk.
- Those with atherosclerois may have poor vascularization (blood flow), so distal body parts such as earlobes may crease when they don’t have the hydration and vascularization as other ears do.
- Collagen and elastic fibers may lose their elasticity from poor vascularization.
- Many times the body expresses a sign dermatologically when pathological processes are beneath the skin. Frank’s sign could be one of the many dermatological manifestations of internal disease like acanthosis nigracans.
Famous people known to have prominent wrinkles as well as Frank’s sign include President George W. Bush and Mel Gibson.
Again, the forehead wrinkles or diagonal earlobe crease does not necessarily mean one has heart disease or will suffer a stroke. However it may not hurt to be evaluated for cardiac risk factors such as high cholesterol, hypertension, diabetes etc. as many studies hint to its cardiovascular relationship.