Subtle change to the EARLOBE that shows you may be at risk of a heart attack or stroke

A subtle but visible change in the skin of the earlobe is a sign of heart disease — indicating a person is at risk of a heart attack or stroke, research shows. 

Doctors may examine the earlobes of patients with suspected heart troubles for a diagonal crease that extends backward across the lobe at a 45 degree angle. 

Known as Frank's sign, or diagonal earlobe crease (DELC), the longer and deeper the crease, the greater the risk, according to studies.

Patients with creases in both earlobes and multiple creases are also deemed at greater danger.

Celebrities mentioned in medical literature as having DELC include former President George W Bush, who, despite being known as a keen runner and mountain biker, was diagnosed with cardiovascular disease.

President George W Bush was diagnosed with cardiovascular disease in 2013 despite being a keen runner and mountain biker 

Doctors may examine the earlobes of patients with suspected heart troubles for a diagonal crease that extends backward across the lobe at a 45 degree angle. Known as Frank's sign, or diagonal earlobe crease (DELC), the longer and deeper the crease, the greater the risk

In 2013, President Bush reportedly underwent a routine scan that revealed 'a serious blockage' in one of the arteries supplying his heart.

He underwent an angioplasty, a procedure in which a stent — a mesh metal tube — was implanted into the blocked artery to restore circulation.

Actor James Gandolfini, who played Tony Soprano in the long-running HBO series The Sopranos, died of a heart attack in 2013, also appears to have a DELC.

Oscar-winning film director Steven Spielberg is also cited in a number of medical journals as having a visible DELC, although he has never publicly said he has heart disease.

The phenomenon was first described in 1973 by lung specialist Saunders T. Frank —hence the name — who noted the diagonal line in patients with angina chest pain. 

Since then, numerous studies have found that someone with DELC has confirmed the association.

One found 78 per cent of patients who suffered a fatal heart attack also had DELC.

The reason people with heart disease might develop the crease isn't fully understood however it could be due to changes in the tiny blood vessels that supply the ears.

There may also be a genetic reason — those who have a predisposition to heart disease also have genes that code for wrinkles and creases in the earlobes. 

Actor James Gandolfini, who played Tony Soprano in the long-running HBO series The Sopranos, died of a heart attack in 2013, also appears to have a DELC

The phenomenon was first described in 1973 by lung specialist Saunders T. Frank —hence the name — who noted the diagonal line in patients with angina chest pain

Oscar-winning film director Steven Spielberg is also cited in a number of medical journals as having a visible DELC, although he has never publicly said he has heart disease

Japanese and Chinese men do not seem to develop DELC, research has shown.

Tim Chico, Professor of Cardiovascular Medicine at the University of Sheffield said DELC was 'something cardiologist know about' and that it 'made sense'.  

He added: 'Cardiovascular disease isn't just something that affects the heart, it affects all the blood vessels around the body and all organs. 

'It increases the risk of heart attacks and stroke but also kidney disease and even dementia.

'If we see DELC in a patient, it doesn't change the advice we give. You reduce the risk by not smoking, maintaining a healthy weight, eating a balanced diet and exercising regularly.'

Heart disease is responsible for around 68,000 deaths in the UK each year, or an average of 190 people each day.

In the US, one person dies every 33 seconds from cardiovascular disease — roughly 700,000 annually. 

Other visible manifestations of heart disease include xanthelasmas — small yellow lumps that form around the inner aspect of the eyes.

The reason people with heart disease might develop the crease isn't fully understood however it could be due to changes in the tiny blood vessels that supply the ears. There may also be a genetic reason — those who have a predisposition to heart disease also have genes that code for wrinkles and creases in the earlobes. 

These usually appear along the corners of the upper and lower eyelids and are a sign of high cholesterol. 

Other indicators of raised cholesterol is corneal arcus, a pale white or grey ring around the iris. 

High blood sugar and diabetes risk is associated with a darkening and thickening of the skin in 'fold areas', such as the back of the neck, armpits and groin, known as acanthosis nigricans.

Obesity is also well-known to be associated with an increased risk of heart disease, heart attacks and stroke as well as a host of other health issues.