Harvard Heart Letter

Eyelids as windows into the heart

People who develop yellow bumps on their eyelids often visit a dermatologist to get them removed. They may want to see a cardiologist as well.

Such a skin lesion is actually a cholesterol deposit known medically as xanthelasma (ZAN-thuh-LAZ-muh) — derived from the Greek word for yellow. (The plural is xanthelasmata. You can see what they look like at www.health.harvard.edu/166.) Xanthelasmata are strikingly similar to the cholesterol deposits that develop inside blood vessels and contribute to atherosclerosis. This raises the question of whether the eyelids might provide a diagnostic window into the heart.

A large study on this topic generated a lot of interest at the American Heart Association's annual meeting. Danish researchers found that folks diagnosed with xanthelasmata were 40% more likely than their fellow Danes to develop heart disease — and 51% more likely to have a heart attack — even after the researchers took established cardiac risk factors into account. In a surprise, half of the people who developed one or more xanthelasma had normal cholesterol levels, suggesting that these skin lesions might indeed be an independent sign of heart disease. But this preliminary research has to be confirmed before doctors will know for sure.

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