title: Facial appearance reflects human familial longevity and cardiovascular disease risk in healthy individuals.
abstract: BACKGROUND
  As facial appearance can be readily quantified and skin tissue easily accessed, they could be valuable tools for determining how biological mechanisms influence tissue degeneration with age and, consequently, human health and lifespan. It is unknown, however, whether appearance reflects disease risk or lifespan independently of factors already known to associate with both health and appearance.
  
  
  METHODS
  In a cross-sectional study, we compared the amount of skin wrinkling on a sun-protected site (upper inner arm) and the facial appearance of 261 offspring (mean age 63.2 y) of nonagenarian siblings with 253 age-matched controls (mean age 62.7 y), all with no reported disease history. We next examined whether any appearance features that significantly associated with familial longevity also associated with the Framingham cardiovascular disease (CVD) risk score. All analyses were adjusted for chronological age, smoking, photodamage, and body mass index.
  
  
  RESULTS
  Female and male offspring had reduced upper inner arm skin wrinkling (p = .03 and p < .001, respectively), and the male offspring looked 1.4 y younger than the controls (p = .002). There were no significant associations between CVD risk and upper inner arm skin wrinkling. Women in the lowest quartile of CVD risk looked more than 2 y younger for their age than those in higher risk quartiles (p = .002). Systolic blood pressure was the most significant (p = .004) CVD risk factor that was associated with perceived age in women.
  
  
  CONCLUSIONS
  Facial appearance and skin wrinkling at a sun-protected site reflect the propensity to reach an extreme old age, and facial appearance reflects the risk of succumbing to CVD independently of chronological age, smoking, photodamage, and BMI.
authors.affiliation: Unilever Discover, Colworth House, Sharnbrook, Bedfordshire, UK. david.gunn@unilever.com
authors.forename: David A
authors.initials: DA
authors.lastname: Gunn
authors.forename: Anton J M
authors.initials: AJ
authors.lastname: de Craen
authors.forename: Joanne L
authors.initials: JL
authors.lastname: Dick
authors.forename: Cyrena C
authors.initials: CC
authors.lastname: Tomlin
authors.forename: Diana
authors.initials: D
authors.lastname: van Heemst
authors.forename: Sharon D
authors.initials: SD
authors.lastname: Catt
authors.forename: Tamara
authors.initials: T
authors.lastname: Griffiths
authors.forename: Stephanie
authors.initials: S
authors.lastname: Ogden
authors.forename: Andrea B
authors.initials: AB
authors.lastname: Maier
authors.forename: Peter G
authors.initials: PG
authors.lastname: Murray
authors.forename: Christopher E M
authors.initials: CE
authors.lastname: Griffiths
authors.forename: P Eline
authors.initials: PE
authors.lastname: Slagboom
authors.forename: Rudi G J
authors.initials: RG
authors.lastname: Westendorp
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology / Q000502:physiology; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D019066:Facies; D005260:Female; D006801:Humans; D008136:Longevity / Q000235:genetics* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012727:Sex Characteristics; D035781:Siblings; D015595:Skin Aging / Q000473:pathology