The yellow patches on the upper or lower eyelids (xanthelasmata)
could predict individual's increased risk of heart attack or other illness, according to a research published on BMJ.
The study, led by Professor Anne Tybjærg-Hansen at the University of Copenhagen, also concludes that white or
grey rings around the cornea (arcus corneae) are not linked to an increased
Previous research has established that both xanthelasmata
and arcus corneae are deposits of cholesterol. However, around half of the
individuals who have either or both condition will not test positively for high
cholesterol in a blood test.
The researchers wanted to investigate links between
xanthelasmata and/or arcus corneae and an increased risk of heart attack, heart
disease, stroke, severe thickening of the arteries or premature death in the
general population, as the evidence in this area is lacking.
Indeed, many patients are referred to dermatologists so that
xanthelasmata can be removed, they add.
They surveyed 12,745 individuals who had participated in the
Copenhagen City Heart Study. The participants were aged between 20 and 93 and
were free of heart disease when the study began. They were followed from 1976-8
until May 2009 with 100% complete follow-up.
At the beginning of the study 563 (4.4%) of participants had
xanthelasmata and 3,159 (24.8%) had arcus corneae.
During the follow-up 1,872 of the participants had a heart
attack, 3,699 developed heart disease, 1,498 had a stroke, 1,815 developed
cerebrovascular disease and 8,507 died.
The results show that in all age groups for both men and
women, the risk of having a heart attack, developing heart disease or dying
within a ten year period increased in individuals with xanthelasmata. This
increased risk is independent of other well-known risk factors such as gender,
smoking, obesity or high blood pressure and cholesterol levels.
The highest risks were found in men between the ages of 70
and 79. Those with xanthelasmata had a 53% increased risk compared to the 41%
risk for men without the condition - an absolute increase of 12%. The
corresponding figures for women were 35% and 27%.
In contrast, the results show that arcus corneae is not a
significant independent risk predictor for heart attack or heart disease.
The authors conclude that the presence of xanthelasmata
could help clinicians when they diagnose heart disease and associated
conditions. And they add that their findings "could be of particular value in
societies where access to laboratory facilities and thus lipid profile
measurement is difficult."
An accompanying editorial concludes that, overall, the evidence
highlights the importance of a comprehensive physical examination and suggests
that xanthelasmata could be used by general clinicians to help identify people
at higher risk of cardiovascular disease.