Research presented today (26 August) at the ESC Congress
2018, the annual conference of the European Society of Cardiology in Munich suggests
that people who have lots of deep forehead wrinkles –  more than is typical for their age, – may have
a higher risk of dying of cardiovascular disease (CVD).

“You can’t see or feel risk factors like high cholesterol or
hypertension,” says study author 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 could include straightforward 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,” Dr Esquirol
points out.

According to the study authors, previous research has
analysed different visible signs of ageing to see if they can presage
cardiovascular disease.  In prior studies, crow’s feet showed no relationship
with cardiovascular risk but these tiny wrinkles near the eyes are a
consequence not just of age but also of facial movement. A link has been
detected 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.

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 3200 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

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,

“The higher your wrinkle score, the more your cardiovascular
mortality risk increases,” explains Dr Esquirol.

Furrows in your brow are not a better method of evaluating
cardiovascular risk than existing methods, such as blood pressure and lipid
profiles, but they could raise a red flag earlier, at a simple glance.

The researchers don’t yet know the reason for the
relationship, which persisted even when factors like job strain were taken into
account, but theorise that it could have to do with atherosclerosis, or
hardening of the arteries due to plaque build-up.

Changes in collagen protein and oxidative stress seem to
play a part both in atherosclerosis and wrinkles.  Also, blood vessels in
the forehead are so small they may be more sensitive to plaque build-up meaning
wrinkles could one of the early signs of vessel ageing.

“Forehead wrinkles may be a marker of atherosclerosis,” says
Dr 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,” cautions Dr Esquirol, “but the practice could be
used now in physicians’ offices and clinics.” 

“It doesn’t cost anything and there is no risk,” concluded
Dr Esquirol.