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Are ear lobe creases related to heart disease?
I never thought much about them in the past until I saw them in my ears. I have one in my right ear lobe, and one and a half in my left ear lobe. I have made the fatal mistake of looking it up on Google as I had been told in the past that this can indicate heart disease or the potential threat of it. Now, I am in a panic,I don't remember seeing them a year ago, or if I did, I didn't give them much thought. To my knowledge, I have a healthy heart; I had an echocardiogram back in 2012 and it was "normal"
I have literally never heard any such a thing in my life.. The google search was extremely interesting though..
Evidently these creases "Franks Sign" were at one point... Before my time it would seem... Considered to be an important marker of cardiovascular disease.
A comprehensive study in the year 2000 looked at data from an absurd sample size (they took over 1,000 from a pool of 120,000 cases).
They found those with Franks sign (ear lob creases) did in fact have a higher risk of CAD.
Predictive value and practical utility however was a bit limited. The presence of Franks Sign/Creases predicted CAD with a sensitivity of 60% and a specificity of 48%.
What this means is that out of everyone with heart disease 60% have the creases!
Out of everyone with creases 48% had heart disease.
Stunned by these results, the study dug a bit deeper and looked at socioeconomic factors (diet and lifestyle), age (as mentioned by Ger), gender and ethnicity. What they found was that those subsets that are known to be more vulnerable to CAD (heart disease), also tended to be those who had the Franks sign!
This means that it is next to impossible to determine if the creases are caused by the disease or some other factor present in these groups! It also means that there is no information that one can get by looking at the ears that they can not also get through patient history/demographic data.
Basically; The predictive value of creases is essentially the same as the predictive value of just asking a patient some simple questions about their history.
Further, while 60%/48% is certainly useful in identifying a sliver of the population that may be at higher risk, thats the extent of it. The study focused on those with Diabetes, a high risk population to begin with, accounting for 10% of the population. According to the study more than half of all these people have the sign and about half of those have CAD, roughly 2.5%-3.5% of the population.
Roughly 20%-30% of the population at large will develop heart disease diagnosed or undiagnosed. So if we went by ear lobe creases alone we only have sufficient evidence that would support us capturing about 10% of these, and we'd be running unnecessary tests on quite a number of patients who would come up negative. We'd only be getting slightly better results then we would using some arbitrary criteria such as "people with big noses" or something.
Mildly useful, but when weighed against modern technology and the plethora of other tests and techniques available its negligable. Hence it's no longer utilized or taught to this generation of students. It is not part of any exam used today.
This has been a good history lesson though, and Ima start looking at earlobe creases just for kicks! :D Who knows? It may actually be usefull in a farfetched situation where literaly everything else is inconclusive. When even the nucmed cameras suffer some sort of critical malfunction, every ekg and stress is borderline, echo shows some absurdly miniscule wall motion abnormality and history is only somewhat impressive (e.g. "I get short of breath with exercise half the time, and it only gets worse with intensity half the time.. Exactly.. Half"); we may actually have to say "Well he DOES have the creases..". Such a scenario would be extremely farfetched.
As for your actual question:
The data supports you being at higher risk based off your creases, especially if you're a diabetic! However compared to an echo, ekg, labs and/or the presence of symptoms (such as unusual or extreme shortness of breath with exercise) it's unimportant.
If you've been "out of shape" lately, you are a bit overweight, are a smoker, are aging or if your diet is less than ideal; it will come as no shock that you are at higher risk. Don't need ear lobe creases to tell you that one. According to everything I found the creases should tell you what you already know.
Some source material:
http://onlinelibrary.wiley.com/doi/10.1111/j.1445-5994.2000.tb00858.x/abstract;jsessionid=568E91FA636BBA27F88F710CB4A72BE6.f03t02?systemMessage=Please+be+advised+that+we+experienced+an+unexpected+issue+that+occurred+on+Saturday+and+Sunday+January+20th+and+21st+that+caused+the+site+to+be+down+for+an+extended+period+of+time+and+affected+the+ability+of+users+to+access+content+on+Wiley+Online+Library.+This+issue+has+now+been+fully+resolved.++We+apologize+for+any+inconvenience+this+may+have+caused+and+are+working+to+ensure+that+we+can+alert+you+immediately+of+any+unplanned+periods+of+downtime+or+disruption+in+the+future.
Evidently these creases "Franks Sign" were at one point... Before my time it would seem... Considered to be an important marker of cardiovascular disease.
A comprehensive study in the year 2000 looked at data from an absurd sample size (they took over 1,000 from a pool of 120,000 cases).
They found those with Franks sign (ear lob creases) did in fact have a higher risk of CAD.
Predictive value and practical utility however was a bit limited. The presence of Franks Sign/Creases predicted CAD with a sensitivity of 60% and a specificity of 48%.
What this means is that out of everyone with heart disease 60% have the creases!
Out of everyone with creases 48% had heart disease.
Stunned by these results, the study dug a bit deeper and looked at socioeconomic factors (diet and lifestyle), age (as mentioned by Ger), gender and ethnicity. What they found was that those subsets that are known to be more vulnerable to CAD (heart disease), also tended to be those who had the Franks sign!
This means that it is next to impossible to determine if the creases are caused by the disease or some other factor present in these groups! It also means that there is no information that one can get by looking at the ears that they can not also get through patient history/demographic data.
Basically; The predictive value of creases is essentially the same as the predictive value of just asking a patient some simple questions about their history.
Further, while 60%/48% is certainly useful in identifying a sliver of the population that may be at higher risk, thats the extent of it. The study focused on those with Diabetes, a high risk population to begin with, accounting for 10% of the population. According to the study more than half of all these people have the sign and about half of those have CAD, roughly 2.5%-3.5% of the population.
Roughly 20%-30% of the population at large will develop heart disease diagnosed or undiagnosed. So if we went by ear lobe creases alone we only have sufficient evidence that would support us capturing about 10% of these, and we'd be running unnecessary tests on quite a number of patients who would come up negative. We'd only be getting slightly better results then we would using some arbitrary criteria such as "people with big noses" or something.
Mildly useful, but when weighed against modern technology and the plethora of other tests and techniques available its negligable. Hence it's no longer utilized or taught to this generation of students. It is not part of any exam used today.
This has been a good history lesson though, and Ima start looking at earlobe creases just for kicks! :D Who knows? It may actually be usefull in a farfetched situation where literaly everything else is inconclusive. When even the nucmed cameras suffer some sort of critical malfunction, every ekg and stress is borderline, echo shows some absurdly miniscule wall motion abnormality and history is only somewhat impressive (e.g. "I get short of breath with exercise half the time, and it only gets worse with intensity half the time.. Exactly.. Half"); we may actually have to say "Well he DOES have the creases..". Such a scenario would be extremely farfetched.
As for your actual question:
The data supports you being at higher risk based off your creases, especially if you're a diabetic! However compared to an echo, ekg, labs and/or the presence of symptoms (such as unusual or extreme shortness of breath with exercise) it's unimportant.
If you've been "out of shape" lately, you are a bit overweight, are a smoker, are aging or if your diet is less than ideal; it will come as no shock that you are at higher risk. Don't need ear lobe creases to tell you that one. According to everything I found the creases should tell you what you already know.
Some source material:
http://onlinelibrary.wiley.com/doi/10.1111/j.1445-5994.2000.tb00858.x/abstract;jsessionid=568E91FA636BBA27F88F710CB4A72BE6.f03t02?systemMessage=Please+be+advised+that+we+experienced+an+unexpected+issue+that+occurred+on+Saturday+and+Sunday+January+20th+and+21st+that+caused+the+site+to+be+down+for+an+extended+period+of+time+and+affected+the+ability+of+users+to+access+content+on+Wiley+Online+Library.+This+issue+has+now+been+fully+resolved.++We+apologize+for+any+inconvenience+this+may+have+caused+and+are+working+to+ensure+that+we+can+alert+you+immediately+of+any+unplanned+periods+of+downtime+or+disruption+in+the+future.
Hi, I would not worry about it. I do not believe there is a serious relationship between ear lobe creases and heart disease.
Of course, when you get older, chances of creases increase as well as chances of heart disease. The common factor is the getting older.
Of course, when you get older, chances of creases increase as well as chances of heart disease. The common factor is the getting older.
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Thank you Ger57. That makes a lot of sense.
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