Common visible signs of aging may not just be vanity or employment problems. They may also be a harbinger of heart disease.
In a large, long-term study, people who displayed three to four signs of aging, such as receding hairlines at the temples, baldness at the crown of the hear, earlobe creases or yellow fatty deposits around the eyelids had a 57-per-cent increased risk of heart attack and a 39-per-cent increased risk of developing heart disease, Danish researchers found.
Fatty cholesterol deposits around the eyes, a condition know as xanthelasmata, were the strongest individual predictor of both heart attack and heart disease, according to data presented this week at the American Heart Association scientific meeting in Los Angeles. There was a 35-per-cent increase in heart attacks among subjects with the condition, researchers found.
"The visible signs of aging reflect physiologic or biologic age and are independent of chronologic age," said Dr. Anne Tybjaerg-Hansen, lead investigator of the Copenhagen Heart Study and a professor of clinical biochemistry at the University of Copenhagen.
Researchers were able to rule out grey hair and wrinkles as predictors of heart disease. Tybjaerg-Hansen, a youthful looking 60-year-old, said those factors appear to reflect chronological age rather than health issues.
Beginning in 1976, researchers analyzed nearly 11,000 subjects aged 40 and older for a variety of common aging signs. Of them, 7,537 had receding hairlines at the temples, 3,938 had baldness at the crown of the head, 3,405 had earlobe crease and 678 sported fatty deposits around the eye.
In 35 years of follow-up through May of 2011, 3,401 of those subjects developed heart disease and 1,708 suffered a heart attack, researchers found.
The aging signs predicted risk of heart attack and heart disease independent of traditional risk factors, such as high cholesterol, high blood pressure and smoking, researchers said.
The risk increased with each additional sign of aging in all age groups among men and women, with the highest risk found among those who had three or four of the problematic signs.
Having yellowish eyelid bumps, which could be signs of cholesterol buildup, conferred the most risk, researchers found. Baldness in men has been tied to heart risk before, possibly related to testosterone levels. They could only guess why earlobe creases might raise risk.
"Checking these visible signs of aging should be a routine part of every doctor's physical examination," Tybjaerg-Hansen said.
Tybjaerg-Hansen, who got involved in the Copenhagen study in the late 1980s, said lifestyle changes and more intensive lipid-lowering therapy should be considered for patients who look older than their age.
Having yellowish eyelid bumps could be signs of cholesterol buildup. Baldness in men has been tied to heart risk before, possibly related to testosterone levels. They could only guess why earlobe creases might raise risk.
One limitation of the study was that it followed an all-white population, so the results cannot necessarily be applied to other races and ethnic groups without further study, she said.
Dr. Kathy Magliato, a heart surgeon at St. John's Health Center in Santa Monica, Calif., said doctors need to pay more attention to signs literally staring them in the face.
"We're so rushed to put on a blood pressure cuff or put a stethoscope on the chest" that obvious, visible signs of risk are missed, she said.