Forehead wrinkles - an early sign of cardiovascular disease?

New research suggests that deep forehead wrinkles might be a quick and easy way to spot individuals at risk of atherosclerosis, a cardiovascular condition that can lead to more serious issues such as a heart attack or stroke.

In atherosclerosis, plaque builds up inside the arteries, making them less elastic and narrowing them down over time.

This limits the supply of oxygen-rich blood to the body's major organs, which, in turn, may lead to a range of diseases — depending on which organ is affected.

When plaque accumulates inside the coronary arteries, coronary heart disease and even heart attacks may ensue.

Some of the main risk factors for atherosclerosis include smoking, high cholesterol levels, insulin resistance, high blood pressure, physical inactivity, age, and a family history of heart disease.

New research adds another risk factor to the list — and one that may be more easy to detect than high blood pressure or insulin resistance. Deep forehead wrinkles, say the authors of the new study, may signal atherosclerosis.

The new research was presented at the 2018 annual conference of the European Society of Cardiology, held in Munich, Germany.

Study author Yolande Esquirol, who is an associate professor of occupational health at the Centre Hospitalier Universitaire de Toulouse in France, shares what motivated the research. "You can't see or feel risk factors like high cholesterol or hypertension," she says.

"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."

This is not the first time that facial features are explored as a potential marker of cardiovascular health. For example, male pattern baldness and prematurely gray hair have been found to raise heart disease risk by fivefold in previous studies.

Cardiovascular death risk 10 times higher

Esquirol and colleagues examined forehead wrinkles in 3,200 healthy adults, aged 32–62 at baseline. The researchers assessed the participants' wrinkles by applying a score ranging from 0 ("no wrinkles") to 3 ("numerous deep wrinkles").

The scientists clinically followed the participants for 2 decades. During this time, 233 participants died of various conditions.

Overall, the research revealed a directly proportional link between wrinkle score and risk of dying from a cardiovascular problem.

While a wrinkle score of 1 elevated cardiovascular death risk only slightly, people with a wrinkle score of 2 and 3 were almost 10 times more likely to die a cardiovascular death than people with wrinkle scores of 0.

These results were obtained after the scientists accounted for age and job strain in their analysis.

Why wrinkles may signal atherosclerosis

While the prospective research was observational, the researchers speculate that the missing link between wrinkle scores and the probability of cardiovascular death may be atherosclerosis.

They base this theory on the fact that both wrinkles and atherosclerosis are subject to oxidative stress and changes in collagen protein levels.

Also, the researchers explain, blood vessels in the forehead are particularly fine, which could mean they are more sensitive to the buildup of plaque that is a hallmark of atherosclerosis.

Finally, the authors suggest that forehead wrinkles could be an easier and much less costly way of determining whether someone has the condition than lipid tests and blood pressure measurements.

"Forehead wrinkles may be a marker of atherosclerosis," says 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 adds.

"[B]ut the practice could be used now in physicians' offices and clinics," she explains, referring to the use of wrinkle scores as a way to detect signs of cardiovascular conditions. "It doesn't cost anything, and there is no risk."