Deep forehead wrinkles may indicate a higher risk of cardiovascular mortality reveals this study from the Toulouse University Hospital, presented at the 2018 Congress of the European Society of Cardiology (Munich). This finding may offer an immediate way to detect elevated cardiovascular risk in primary care.
While risk factors such as high cholesterol or hypertension are not immediately noticeable, forehead wrinkles as a simple, visual marker, provide an opportunity just by looking at a patient's face, to suspect risk, d refer the patient to additional examinations and provide lifestyle advice to reduce his risk. The risk of heart disease increases as people age, but lifestyle and medical interventions can reduce it. The challenge remains to identify high-risk patients early enough to make a difference.
Previous research has already looked at whether different visible signs could predict the development of cardiovascular disease. A link has thus already been detected between male pattern baldness, earlobe folds, xanthelasma (pockets of cholesterol under the skin) and a higher risk of heart disease, with an increased risk of death.
The French researchers looked at whether horizontal wrinkles on the forehead could be used to assess cardiovascular risk in 3,200 healthy active adults, aged 32, 42, 52 and 62 at the start of the study. Participants were examined by doctors who assigned scores based on the number and depth of wrinkles on their forehead. A score of zero corresponded to no wrinkles, a score of 3 to many deep wrinkles. Participants were followed for 20 years, during which 233 people died of various causes. Among deceased participants, 15.2% had a wrinkle score of 2 or 3, 6.6% a score of 1, and 2.1% had no wrinkles. The analysis shows a positive association between the wrinkle score and the cardiovascular risk: thus, vs the absence of wrinkles,
- a score of 1 is associated with a slightly higher cardiovascular risk,
- a score of 2 or 3 means an almost 10-fold increased risk of death, and this after adjusting for age, sex, education, smoking, blood pressure, diabetes and lipids.
The higher the wrinkle score, the higher the risk of cardiovascular mortality: thus, if forehead wrinkles are not a better predictor than existing methods, such as blood pressure and lipid profiles, they may allow to suspect the risk of a simple glance and then carry out additional examinations.
What explanation? While the study does not explain the relationship, the researchers suggest that atherosclerosis, or hardening of the arteries due to plaque formation, may be at the root of this association. Changes in collagen proteins and oxidative stress also appear to play a role in both atherosclerosis and wrinkles. Additionally, the blood vessels in the forehead are so small that they may be more susceptible to plaque formation, which could be one of the first signs of aging vessels.
This is the first time that a link has been established between cardiovascular risk and forehead wrinkles, so these results will need to be confirmed in future studies, concludes lead author Dr. Esquirol.
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