Earlobe crease as a marker of coronary heart disease: a systematic review

Earlobe crease (ELC) is a wrinkle-line in the skin that surrounds the ear approximately one third of the length between the tragus and the posteroinferior edge of the earlobe. Since the first study in 1973, the relationship between ELC and coronary heart disease (CHD) remains unclear. In addition, the pathogenesis of ELC has not well described, yet. This review aimed to evaluate the relationship between CHD and the presence of ELC using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) protocol. Eligible studies obtained from PubMed and Google Scholar using relevant keywords were collected. The assessment of quality of the studies was carried out based on the National Heart Lung and Blood Institute. Among 21 studies collected, 19 studies reported a correlation between the ELC and CHD indicating that ELC as a potential marker of CHD. Seven studies reported a significant association of ELC with CHD after adjusting confounding variables such as age, sex and other risk factors for atherosclerosis in analysis. Seven studies reported that subjects with ELC had more significantly severe CHD based on coronary angiography. The sensitivity of the ELC was reported between 30-98% and the specificity between 43-91%. Two studies reported no relationship between ELC and CHD after adjustment of age in analysis. Earlobe crease is a dermatological sign which was reported to have potential as a marker of CHD. Further study with large sample in population from various ethnics is needed in order to obtain a robust conclusion regarding the clinical importance of ELC in predicting CHD

Cardiovascular Risk Profile in Health Cadres in Jatinangor, West Java

Background: Cardiovascular disease has very high morbidity and mortality, therefore, prevention of this disease becomes a national priority in the health programs. Health cadres, as an agent in community primary prevention, should have a good health condition. This study aimed to describe the cardiovascular risk profile in health cadresin Jatinangor, West Java.Methods: This was a cross-sectional study, conducted in Cilayung Village, Jatinangor, in September 2018. Consecutive sampling was performed on 20 health cadres aged 25 - 64 years old who did not have previous cardiovascular events such as coronary heart disease or stroke. Clinical data were collected consisting of blood pressure, body mass index (BMI), random blood glucose, history of diabetes mellitus, physical activity and active smoking habits. Cardiovascular risk was assessed using Jakarta cardiovascular scores and European Relative Risk Score.Results: Only 17 of 20 health cadres fulfilled the inclusion criteria with a systolic and diastolic blood pressure of 133.5±27.8 mmHg and 81.1±14.8 mmHg, respectively, and BMI of 27.4±5.3 kg/m2.The risk of cardiovascular disease in healthy cadres was at low (47.1%), moderate (41.2%) and high risk (11.7%). The average of the European Relative Risk score was 1.88±0.9. BMI >30 has a 40% high risk of cardiovascular disease.Conclusions: Most of the health cadres in Jatinangor, West Java have a low and moderate risk of cardiovascular disease, even though there is a small percentage that is at a high risk. The awareness for prevention and management programs for risk factors needs to be raised among health cadres. .