A new French study finds that people with deep forehead wrinkles — more than is typical for their age — may be at greater risk for dying of cardiovascular disease (CVD).

The findings, recently presented at the European Society of Cardiology (ESC) Congress 2018, suggest that simply assessing forehead wrinkles could be an easy, low-cost way to identify people in a high-risk category for CVD.

“You can’t see or feel risk factors like high cholesterol or hypertension,” said study author Dr. 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.”

That advice might involve simple lifestyle changes like getting more exercise or eating healthier food.

“Of course, if you have a person with a potential cardiovascular risk, you have to check classical risk factors like blood pressure as well as lipid and blood glucose levels, but you could already share some recommendations on lifestyle factors,” said Esquirol.

As we get older, the risk of heart disease increases, but lifestyle and medical interventions can help offset the danger. The challenge is in identifying high-risk patients early enough to make a difference.

Previous studies have analyzed different visible signs of aging to see if they can help forewarn cardiovascular disease. So far, researchers have detected a link 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.

No link was found between crow’s feet (tiny wrinkles near the eyes) and cardiovascular risk, but these wrinkles are also the result of facial movement, rather than aging alone.

The authors of the new study looked at 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 healthy, working adults (ages 32, 42, 52 and 62 at the beginning of study).

Participants were evaluated by physicians who assigned scores depending on the number and depth of wrinkles on their foreheads. For example, a score of zero meant no wrinkles while a score of three meant “numerous deep wrinkles.”

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

The findings reveal that those with a 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,” says Esquirol.

Although brow wrinkles are not necessarily a better method of evaluating cardiovascular risk than existing methods, such as blood pressure and lipid profiles, they could still raise a red flag earlier, at a simple glance.

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

In addition, changes in collagen protein and oxidative stress seem to play a part both in atherosclerosis and wrinkles. And blood vessels in the forehead are so small they may be more sensitive to plaque buildup, meaning wrinkles could one of the early signs of vessel aging.

“Forehead wrinkles may be a marker of atherosclerosis,” said Esquirol.

“This is the first time a link has been established between cardiovascular risk and forehead wrinkles so the findings do need to be confirmed in future studies,” she said, “but the practice could be used now in physicians’ offices and clinics. It doesn’t cost anything and there is no risk.”

Source: European Society of Cardiology