Are earlobe creases a sign of heart disease?

September 2, 2009

Dear Cecil:

Do earlobe creases really indicate you may have coronary heart disease?

Cecil replies:

You may say: This is the dumbest thing I’ve ever heard. But read some Straight Dope mail and you'll realize dumbest-thing-ever is a pretty high bar. More to the point, earlobe creases shouldn’t be dismissed lightly, as they fall into the surprisingly large category of weird signs possibly indicative of heart disease. If you doubt it, have a seat while we inventory your personal issues, as it were. You might think you've got problems now, but in reality things may be oh so much worse.

Earlobe crease (ELC), i.e., a line running diagonally from the bottom of the ear opening to the ear's lower tip. I first discussed this in 1997 (The Straight Dope: Why do older men have hair growing in their noses and ears?), observing that, based on research then available, if you had hairy ears with creased lobes, you were basically a heart attack waiting to happen. The jury's still out on the hairy part, but ELC's status as portent of doom has been abundantly confirmed:

  • A Swedish study of 520 autopsies found ELC had a "positive predictive value" for coronary artery disease of 68 percent — 80 percent in those under 40.
  • A Turkish study found ELC was a higher risk factor for heart disease than diabetes, family history of cardiovascular trouble, or smoking.
  • Of 340 patients admitted to the Montreal Heart Institute, 91 percent of those with ELC had heart disease versus only 61 percent of those without.
  • An Irish study of 247 patients found ELC had a predictive value of 71 percent for heart disease, showing what statisticians call low sensitivity but high specificity. Translated: if you don't have ELC, that doesn't necessarily mean you don’t have heart disease, but if you do have ELC, it's a pretty good bet you do. (To be fair, other research hasn't found as strong a correlation.)

Why a connection between ELC and heart disease? Nobody knows. The most plausible theory I've heard is that ELC indicates premature aging.

You don't have creased lobes? You're not off the hook yet. We continue with our checklist of heart disease signs:

Retinopathy. This is a catchall term for several types of retina disorder often found in diabetics. If you're a nondiabetic with one of these conditions, you have a 33 percent greater chance of experiencing coronary heart disease.

Ring finger length. According to Liverpool University researchers, a short ring finger in males = lower level of testosterone = higher risk of heart attack early in life. How do we define short? Typically a guy’s ring finger is slightly longer than his index finger. So divide your index finger length by your ring finger length. If the resulting ratio is greater than 1.0 (i.e., index finger is longer than ring finger), you're at greater risk for early heart attack. If it’s less than 0.9 (index finger considerably shorter), your risk of early heart attack is low.

Male pattern baldness. The largest study to date, which looked at more than 22,000 male doctors over 11 years, found men with frontal baldness were about 9 percent more likely to have heart disease than their nonbalding peers, while those with baldness at the crown (top) of their heads were 23 to 36 percent more likely — and the balder you are, the higher the risk. On the plus side, while a 2007 study at the University of Arizona confirmed that baldness = higher heart disease risk, it also concluded baldness wasn't a reliable indicator all by itself.

Bad breath — specifically, bad breath due to gum disease. Some studies claim people with lots of antibodies due to bum gums have a 50 to 100 percent greater chance of heart disease. One study found treating gum disease could reduce thickening of the carotid arteries.

Acne, absence of. A study of 11,000 UK males found that men who had acne as teenagers had a 30 percent lower chance of dying from cardiovascular or heart disease later in life. Unfortunately, they also had twice the risk of dying from prostate cancer.

Green snot. An upcoming paper in Biochemical Journal reportedly shows a connection between heart disease and green snot, which is caused by an enzyme called myeloperoxidase. The enzyme fights bacteria by producing hypochlorous acid, which can also damage your body's tissues and lead to asthma, arthritis, and atherosclerosis.

Earwax. Here's an amazing fact you'll want to trot out next time you get invited to dinner at the White House. There are two kinds of earwax: gray, brittle, and dry; and brown, sticky, and wet. You produce just one kind or the other throughout your life — earwax type appears to be hereditary. In 1966 a Japanese study seemed to show that dry earwaxers had a greater risk of arteriosclerosis than wet earwaxers. This observation has never been confirmed, and a later reviewer rightly notes that such results should be regarded with suspicion. But if you're going to worry about snot and bad breath, you might as well worry about earwax, too.

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References

Celik, Sukru, et al. “Diagonal ear-lobe crease is associated with carotid intima-media thickness in subjects free of clinical cardiovascular disease.” Atherosclerosis 192 (2007): 428–431.

Frank, Saunders T. “Aural sign of coronary-artery disease.” New England Journal of Medicine 289 (1973): 327–328.

Edston, E. “The earlobe crease, coronary artery disease, and sudden cardiac death: an autopsy study of 520 individuals.” American Journal of Forensic Medical Pathology 27.2 (2006): 129-133.

Evrungul, Harun, et al. “Bilateral Diagonal Earlobe Crease and Coronary Artery Disease: A Significant Association.” Dermatology 209.4 (2004): 271-275.

Moraes, D. et al. “Ear lobe crease and coronary heart disease.” Irish Journal of Medicine 85.4 (1992): 131-132.

Elliott, William, and Karrison, T. “Increased all-cause and cardiac morbidity and mortality associated with the diagonal earlobe crease: a prospective cohort study.” American Journal of Medicine 91.3 (1991): 247-54.

Morton, Newton E. “Genetic markers in atherosclerosis: A review.” Journal of Medical Genetics 13 (1976): 81-90.

Liew, G. et al. “Retinopathy predicts coronary heart disease mortality.” Heart 95 (2009): 391-394.

Gutersohn, Thomas and Scheidegger, E. Paul. “Is Baldness Bad for the Heart?” Dermatology 211 (2005): 72-74.

Manning, J.T., and Bundred, P.E. “The ratio of second to fourth digit length and age at first myocardial infarction in men: A link with testosterone?” British Journal of Cardiology 8.12 (2001): 720-723.

Lotufo, Paulo A. et al. “Male Pattern Baldness and Coronary Heart Disease: The Physician’s Health Study.” Archives of Internal Medicine 160 (2000): 165-171.

Galobardes, B. et al. “Acne in Adolescence and Cause-specific Mortality: Lower Coronary Heart Disease but Higher Prostate Cancer Mortality: The Glasgow Alumni Cohort Study.” American Journal of Epidemiology 161.12 (2005): 1094-1101.

Hujoel, Philippe P. et al. “Periodontal Disease and Coronary Heart Disease Risk.” JAMA 284.11 (2000): 1406-1410.

Pussinen, Pirkko J. et al. “Antibodies to Periodontal Pathogens Are Associated With Coronary Heart Disease.” Arteriosclerosis, Thrombosis, and Vascular Biology 23 (2003): 1250-1254.

Beck, James D. et al. “Periodontal Disease and Coronary Heart Disease: A Reappraisal of the Exposure.” Circulation 112 (2005): 19-24.

Shahar, Eyal et al. “Baldness and Myocardial Infarction in Men: The Atherosclerosis Risk in Communities Study.” American Journal of Epidemiology (2008): 1-8.

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