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Cardio-vascular Health

Coronary Heart Disease, CHD

Another Look At The Earlobe Crease

By Dr. W. Gifford Jones

December 12, 1992

Do people with an earlobe crease have a greater chance of developing coronary heart disease? Or is there another explanation that will reassure readers who discover a definite crease in their ear lobes?

Several years ago I doffed my hat to Dr. William Elliott, Assistant Professor of Medicine, at the University of Chicago. Why? Because too many doctors have become "testing" rather than "thinking" physicians. They have become addicted to the worship of diagnostic technology and have lost the "art" of medicine.

Dr. Elliott helped to restore that art by making an interesting discovery. He examined 1,000 patients with coronary heart disease (CHD). He noticed that 74 per cent of these patients exhibited a peculiar ear crease. In contrast only 16 per cent without the crease suffered from CHD.

Another study covering 6,000 patients confirmed that 60 per cent of those with an earlobe crease suffered heart disease.

I admit I had some concern about reporting this finding. I had visions of readers rushing to the mirror to see if they have an earlobe crease. Then worrying themselves to death if they found one. Or concerned that a coronary by©pass operation was needed.

What is an earlobe crease? Dr.Elliott claims the telltale crease starts where the ear lobe attaches to the head. It angles diagonally backwards towards the lower edge of the ear. If it's present it's quite obvious.

Dr. Elliott's conclusions didn't make much impact on the medical world. But an eight year follow©up of his original patients revealed that those with an earlobe crease did indeed fare worse than those without it.

The eight year mortality rate for those without an earlobe crease or coronary heart disease was 33 per cent. The rate increased to 57 per cent for those with no earlobe crease but with CHD, 72 per cent for patients with an earlobe crease and no known CHD. And it jumped to 78 per cent for patients who had both the earlobe crease and known CHD.

But is Dr. Elliott right? Dr. Renuka Diwan, Assistant Professor of Dermatology, at Johns Hopkins Medical School, adds another chapter to the earlobe debate.

Ϊ Dr. Diwan asked 234 men and women attending the dermatology clinic which side they tended to sleep on. They were all over 30 years of age and were also questioned about previous heart disease.

The result? A strong association appeared between the side on which a person slept and the presence and severity of an earlobe crease. If the person slept on both sides, bilateral creases were present.

I've no doubt the reasons for the earlobe crease and its significance will continue in medical debate.

What could cause it? Dr. Diwan says, "There's something about aging that makes you get creases." Few of us would disagree with that as we observe our own wrinkles.

With increasing age the skin retains less elasticity. One reason is the loss of collagen which acts like flexible cement to hold cells together. So if the skin becomes creased without collagen it tends to stay creased longer.

Some authorities speculate there may be a gene that determines whether a person develops an earlobe crease. Others contend that the coronary artery disease relationship is purely coincidental and means nothing. Or that the earlobe crease is simply more common in older people who are also more likely to have blocked coronary arteries.

But possibly there is an element of truth that the earlobe crease is "a window to the heart". The earlobe is one of the softest and thinnest parts of the body. It is also well supplied with small blood vessels called arterioles.

Some researchers believe that degeneration of the elastic tissue around the arterioles produces the crease. This is the same type of change associated with hardening of the arteries.

I continue to congratulate physicians who understand there is more to medicine than electrocardiograms and CAT scans. And it costs nothing to look for an earlobe crease! So since there's a little Scottish blood in me I'd like to suggest another study to clarify this issue. Lets examine the earlobes of those who routinely sleep on their backs.

My advice is to keep this finding in its proper perspective. The earlobe crease may simply be another risk factor like genetics, obesity, hypertension, smoking and a sedentary lifestyle.

Readers may wonder if it's possible to prevent an earlobe crease from developing. We can't stop aging. Nor can we change our parents. But if the earlobe crease is related to atherosclerosis the answer is to toss out the cigarettes, keep off the extra pounds, make exercise a way of life, and if Linus Pauling is right take more vitamin C and E. Œ

W. Gifford-Jones M.D Most recent columns

W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is:
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