Heart Disease Risks You’ve Probably Never Heard About
By Alan Reisinger, MD

If you’re trying to protect your heart, you probably already know the things you should do: Eat a healthy diet, get plenty of exercise, manage your weight, minimize stress and make sure you’re seeing your doctor regularly.

But there are other things that can put you at risk for heart disease that you may not even be aware of. Some of them are really unusual (such as living near noisy roads) while others (like crinkled ear lobes) can help identify people at risk earlier than cholesterol tests or blood pressure screenings.

Oral Health

If you were a patient in my practice, chances are you’d know about this connection. For years I’ve preached the gospel that poor oral health and heart disease are linked. While research hasn’t completely explained what’s going on, it’s clear that inflammation in your gums (periodontal disease) can influence the development of atherosclerosis, the buildup of plaque along the walls of your arteries. People with gum disease have a 49 percent chance of having a heart attack. The good news: This is one risk factor you can control by working with your dentist and your primary care doctor.

Sleep 

Not getting enough sleep – less than seven hours a night – creates a host of heart-related risks that you may not be aware of. For example, lack of sleep can impact your blood pressure, put you at risk for type 2 diabetes and encourage unhealthy weight gain.

More severe sleep issues, like sleep apnea and insomnia, can both increase your risk and be an early indicator of heart disease. Sleep apnea happens when your air flow stops while sleeping. This causes stress hormones to be released, contributing to hypertension, stroke and heart disease risk. Insomnia can increase stress, lower your motivation to move and exercise and lead to poor food choices — all of which contribute to heart disease. If you’re not sleeping well, talk to your primary care physician.

Extreme Weather

If you live where lots of snow falls, you’ve probably heard about people having heart attacks while shoveling snow. Heavy snowfall, in fact, is associated with 16 percent greater odds of men being admitted to the hospital with a heart attack, and a 34 percent increase in the chance of men dying from a heart attack. But it’s not just snow. According to a new study published in the journal Circulation, there are more cardiovascular deaths on extreme cold and hot days. It’s a good reminder not to overexert yourself when the weather is bad.

Grip Strength

Remember those old arcade games where you test your grip by squeezing a set of bars? A high grip strength set off bells and lights and made you the envy of others … okay, that didn’t happen for me either.

But there is a connection between your grip strength and cardiovascular risk. Lower grip strengths are associated with heart disease and deaths from the disease. In fact, grip strength is “a stronger predictor of all-cause and cardiovascular mortality than systolic blood pressure,” according to a 2015 study in The Lancet.

Wrinkles, Creases and Hairline

Since 1973, we’ve known about a little quirk in anatomy: People with a diagonal earlobe crease, called Frank’s sign after the doctor who first observed it, are at higher risk of heart disease. People with this crease (called DELC) include the famous such as George W. Bush and Stephen Spielberg. Despite this correlation which includes cerebral vascular events like ischemic stroke, Frank’s sign is not typically used by doctors to measure heart disease risk because there are better tests and screenings to determine risk.

Similar research has linked wrinkly foreheads to a higher risk of heart disease. Could doctors one day diagnose heart disease with a quick glance? Maybe. Similarly, a few years ago researchers in India discovered that male-pattern baldness is associated with a five-fold increase in heart disease risk — greater than obesity — for men under the age of 40.

Your Height

Like creases in your ears and wrinkles in your forehead, you can’t do anything about your height. But unfortunately, it too can increase your risk for heart disease. Researchers have linked genetically related shorter stature with higher blood pressure levels, higher levels of LDL cholesterol (the so-called bad cholesterol) and diabetes. The study authors suggested that some of the genes that cause shorter height may also increase cholesterol levels.

Giving Birth to a Premature Baby

Women who give birth to their first child before 37 weeks of gestation have a 40 percent greater risk of heart disease later in life than women who delivered at full term. For women who gave birth before 32 weeks, the risk doubles verses women who delivered at full term. Another study found that women who give birth to four or more children in their lifetime also have a higher risk of atrial fibrillation compared to women with no pregnancies. 

The Flu

Sadly, influenza can do more than make us miserable for a week: The flu may induce a heart attack. In a five-year-old study, researchers linked incidents of flu to acute heart attacks. Severe respiratory illnesses like the flu put undue stress on our heart, which researchers speculate lead to the higher risk. If you’ve got a severe case of the flu, make sure your primary care doctor knows, especially if you are already at risk for heart disease.

Where You Live

Where you live can also play a role in your cardiovascular risk. Although much of America is in the grips of an obesity epidemic, which increases our risk of heart disease, people who live in the South and the Midwest are particularly at high risk of cardiovascular-related death because of the generally poor cardiovascular health in those regions. This is well known (in fact, part of the South is now referred to as the “stroke belt”) and there are multiple studies demonstrating it.

What’s lesser known is that things like altitude (the higher you live the lower your risk of metabolic syndrome) and latitude (the further you live from the equator, the greater your risk for heart disease). In the case of the former, people who lived at higher altitudes have fewer incidents of metabolic syndrome, a cluster of conditions that include being overweight and having high blood pressure, abnormal cholesterol or excess body fat. Metabolic syndrome raises your risk for heart disease. 

Researchers have been looking at latitude as a factor since the 1970s. Much of the research has speculated that sunlight (increased levels of sunlight lower cholesterol levels), which affect vitamin D levels, may impact our heart disease risk. There was a difference in both blood pressure and cholesterol levels between people living near the equator (BP and cholesterol were lower) and those living farther from it (higher BP and cholesterol levels).

What do these more obscure risk factors mean? Some of them are significant. If you have periodontal disease, talk to your doctor and your dentist. If you’ve had high-risk pregnancies or severe flu, make sure your doctor knows these things. But if you’ve got creased ears, wrinkles on your forehead, male-pattern baldness or live close to the north pole, I wouldn’t worry too much (unless you need to shovel 50 inches of snow from the driveway). 

Worry more if you have other classic risk factors for heart disease like abnormal cholesterol levels, diabetes, hypertension or you’re overweight, sedentary or smoke. These are risks you should work on with your doctor, because mitigating these risks are going to lower your risk for heart disease more than smooth ear lobes.

A good advice (from me, not from an MD): to relax and avoid heart problems, read a good novel by the ABB authors, or even better a box of novels.

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