Ear Creases

If you look in the mirror and see a lot of extra pounds—particularly if they’re settling around your middle—you may be at a higher risk of getting heart disease. But what could a diagonal crease in your earlobe tell you?

The Ear Crease and Heart Disease Connection

In 1973, a study published in the New England Journal of Medicine reported that a diagonal earlobe crease (ELC) was a potential indicator of coronary artery disease (CAD). This crease was later called “Frank’s sign,” after the lead author of the study, Dr. Sanders T. Frank. Whereas a “normal” earlobe is smooth, an earlobe with a crease has a fold, straight line, or wrinkle that appears to cut the earlobe in half. Could such a small mark on your ear really have anything to do with heart disease?

Supporting Studies

Since Frank’s original study in 1973, several more scientists have looked at the potential connection between earlobe creases and CAD. Some studies have shown a connection, while others haven’t. In 1982, Pasternac and colleagues published a study of 340 patients. They found that the earlobe crease was a sign associated with increasing age and CAD.

The crease suggested the presence of a more severe form of heart disease in patients who were showing symptoms. The earlobe crease, the researchers wrote, “may identify a subset of patients prone to early aging and to the early development of coronary artery disease, whose prognosis might be improved by early preventative measures.”

Another study published in 1989 by Kirkham and colleagues studied the bodies of patients who had died from various causes. In their study of a little over 300 bodies, the diagonal creases were associated with cardiovascular causes of death. “We found a strong association between earlobe creases and a cardiovascular cause of death in men and women after age, height, and diabetes had been controlled for,” the researchers wrote.

Another study in 1991 by Elliott and colleagues found similar results. So did a study by Edston in 2006, which reported that the predictive value of an ear crease was as high as 80 percent in individuals younger than 40 years.

Contradictory Studies

However, other studies showed different results. Fisher and colleagues, for example, published a study in 1980 that showed no significant relationship between ELC and CAD in American Indians. This indicates that “Frank’s sign” may not show the same correlation in other ethnic groups. Another study of Japanese Americans living in Hawaii also found no connection. Studies have indicated that the sign may be less indicative in patients who have other important risk factors for CAD, particularly diabetes.

Some studies have theorized that as patients age, the presence of earlobe creases and heart disease increase—especially after they reach the age of 50. This doesn’t necessarily mean that one has to do with the other. This was what a University of Massachusetts Medical School team concluded from their study. They reported that earlobe creases are a simple feature of the aging process in some people.

How Could Ear Creases Indicate Heart Disease?

Although scientists aren’t sure how these two might be connected, there are some theories. Degeneration of the elastic tissue around the small blood vessels that carry blood to the earlobes produces the earlobe crease. This is the same type of change in blood vessels associated with CAD. In other words, visible changes that show up in tiny blood vessels of the ear could indicate similar changes in those blood vessels that can’t be seen around the heart.

Earlobe creases can also be caused by rare disorders like Beckwith-Wiedemann syndrome in children or by genetic factors such as race and earlobe shape. Taking all these factors into consideration, how concerned should you be if you have an earlobe crease?

Use It to Your Advantage

There are enough studies establishing a connection between earlobe creases and heart disease that if you have such a wrinkle on your ear, it’s worth taking seriously. A 2011 NYU School of Medicine student review of the studies concluded that ELC predicts CAD more often than traditional risk factors and that it may be useful for identifying patients with the disease.

First, check with your doctor. Most likely, they’ll conduct further tests to determine your blood pressure, cholesterol levels, and other risk factors you may have. By taking everything—including your ears—into account, you’re more likely to create a clear overall picture of your risk and determine what steps you can take to protect your heart health.