Visible Age-Related Signs and Risk of Ischemic Heart Disease in the General Population: A Prospective Cohort Study
Background—Cardiovascular disease is one of the most common age-related diseases, and also one of the most common causes of death in the general population. We tested the hypothesis that visible age-related signs associate with risk of ischemic heart disease (IHD), myocardial infarction (MI), and death in the general population, independent of chronological age.
Methods and Results—10,885 individuals aged 20-93 years free of IHD were followed from 1976-8 until June 2011 with 100% complete follow-up. During these 35 years of follow-up, 3,401 participants developed IHD and 1,708 developed MI. Presence of frontoparietal baldness, crown top baldness, earlobe crease, and xanthelasmata was associated with increased risk of IHD and/or MI after multifactorial adjustment for chronological age and well-known cardiovascular risk factors. The risk of IHD and MI increased stepwise with increasing number of age-related signs with multifactorially adjusted hazard ratios up to 1.40 (95% confidence interval 1.20 to 1.62) for IHD and 1.57 (1.28 to 1.93) for MI, in individuals with 3-4 versus no age-related signs at baseline (P for trend <0.001). In all age-groups in both women and men, absolute 10-year risk of IHD and MI increased with increasing number of visible age-related signs.
Conclusions—Male pattern baldness, earlobe crease, and xanthelasmata - alone or in combination - associate with increased risk of ischemic heart disease and myocardial infarction independent of chronological age and other well-known cardiovascular risk factors. This is the first prospective study to show that looking old for your age is a marker of poor cardiovascular health.
- Received February 3, 2013.
- Revision received October 8, 2013.
- Accepted October 24, 2013.