When it comes to your cardiovascular health, you might think that if you don’t have any typical risk factors for heart attack or coronary artery disease, such as obesity, high blood pressure or high cholesterol, then your heart is in good shape.

But a new study may make you think twice.

It may sound crazy, but how you look—as in, whether you look young or old for your age—can actually affect your risk for certain cardiovascular problems.

In fact, researchers have pinpointed four specific physical traits.

So check out what the four traits are and then take a look in the mirror…


After studying 35 years of data from nearly 11,000 male and female volunteers, Danish researchers found that two of the traits are fairly common and easy to recognize—a receding hairline and a bald spot on the head. (If a participant was mostly or completely bald, that person was put into the “bald spot” group.) The association of baldness and cardiovascular risk was seen among both men and women, though baldness was much less common in women.

The third trait is a little more obscure—a crease in one or both earlobes. And the fourth is having small, lumpy, yellow deposits on, above, below or next to the eyelids, a condition called xanthelasma that’s caused by excess cholesterol under the skin. (For photos of the last two traits, see below.)

The study showed that the more of these traits a person had, the higher his or her chance of having a heart attack or developing coronary artery disease. For example, the researchers discovered that for people with three or four of these traits, the chances of suffering a heart attack are 57% greater and the chances of developing coronary artery disease are 39% greater, on average, than for people who have none of these traits.

What’s remarkable is that these elevated risks held true even when researchers controlled for other common risk factors for cardiovascular problems, such as age, high blood pressure, high cholesterol, excess weight, poor nutrition, smoking, not exercising, gender and a family history of heart disease.

Why are these traits associated with these serious cardiovascular problems—and what might your doctor be able to do to help treat each trait? I asked the lead author of the study, Anne Tybjaerg-Hansen, MD, DMSc, and here’s what she told me…

Xanthelasma, fatty eyelid deposits.Xanthelasma. This condition remains a mystery to medical science. One potential cause of these fatty eyelid deposits is a diet that includes too much saturated fat—because saturated fat can raise your cholesterol levels. A doctor may advise you to eat a healthier diet and get more exercise, which may help lower your cholesterol numbers and, in turn, prevent more fatty deposits from appearing. But it’s possible to have a normal cholesterol level and still have xanthelasma. Other potential causes of xanthelasma are diabetes, certain cancers and cirrhosis of the liver. You can have the deposits surgically removed, but unless the underlying cause is treated, the deposits may return and your cardiovascular risk would not be reduced.

Hair loss. There are a wide variety of potential causes for hair loss. It could be due to genetics (male pattern baldness)…a hormone imbalance…a drug (for instance, some medications that treat cancer, arthritis, depression and high blood pressure are associated with hair loss)…a thyroid problem…the disease alopecia, in which the immune system destroys hair follicles…a scalp infection…a skin disorder (such as lichen planus or lupus)…emotional or physical shock (due to, say, a death in the family or sudden weight loss)…anxiety (certain mental disorders make people want to pull hair from their heads)…a certain hairstyle (pulling hair too tightly can cause it to break and fall out)…overusing hair products (when hair gets too brittle, it can break and fall out)…or improper nutrition (a lack of iron and protein can cause hair to thin). If you have a treatable condition that’s causing your hair loss, treating the condition may or may not have a positive effect on your cardiovascular risk factors—we don’t know.

Earlobe crease.Earlobe crease. This is a tricky trait. You might have an earlobe crease if the trait is passed down genetically through your family. As far as what else may cause this, that’s up for debate. One theory suggests that it could be due to impaired circulation leading to a collapsed blood vessel near the earlobe. Another theory, which comes from a dermatologist, is that it may develop from a combination of aging and sleeping on one particular side of your body. But the cause is hard to pin down and there aren’t any current treatments for it.

So all in all, it’s not entirely clear why these traits are associated with certain increased cardiovascular risks and it’s not yet known how to counteract these increased risks. But if you have at least one of these traits, Dr. Tybjaerg-Hansen said it probably wouldn’t hurt to talk to your doctor about making more aggressive lifestyle changes, even if you’re already eating some healthy foods and exercising a little. Your test results may lead you to believe that you’re in the clear, but these findings show that you’re not! It’s possible that you’ll need to make more of an effort than most people to protect your heart health.

For more ways your body tells you about a health problem, check the Bottom Line Guide: What Your Body Is Telling You About Your Health.