Frank's Sign and Cardiovascular Risk: An Observational Descriptive Study

Area of Science:

• Cardiology
• Dermatology
• Public Health

Background:

• Cardiovascular diseases remain a leading cause of mortality globally.
• Identifying accessible early indicators of cardiovascular risk is crucial for preventative strategies.
• The diagonal earlobe crease (DELC) has been anecdotally associated with cardiovascular conditions.

Purpose of the Study:

• To investigate the association between the presence and characteristics of a diagonal earlobe crease and cardiovascular risk.
• To analyze anatomical variations of the earlobe crease in relation to cardiovascular risk indices.

Main Methods:

• A cohort of 1050 Spanish adults was assessed for cardiovascular risk factors and events.
• Cardiovascular risk was calculated using established equations (Framingham-Anderson, SCORE, ASCVD).
• Earlobe creases were meticulously examined for presence, laterality, length, depth, and accessory folds, with statistical analysis performed using various tests.

Main Results:

• Individuals with a diagonal earlobe crease exhibited significantly higher estimated cardiovascular mortality risk (P < .001).
• Moderate to very high cardiovascular risk increased progressively with crease presence: 23.8% (none), 35.6% (unilateral), 58% (bilateral).
• Longer, deeper, and accessory creases were independently associated with significantly elevated cardiovascular risk scores (P < .001).

Conclusions:

• The diagonal earlobe crease is an independent predictor of elevated cardiovascular risk.
• The association is stronger with complete, bilateral, deep creases, and the presence of accessory creases.
• Earlobe crease characteristics may serve as a simple, non-invasive marker for cardiovascular risk assessment.