Those with a face full of wrinkles have one more thing to worry about: it could be a harbinger of doom.
A study suggests that a furrowed brow is an early clue to deadly heart problems. Research presented at the world's largest heart conference found that adults with the wrinkliest brows are 10 times more likely to die younger than those with smooth skin.
Scientists said horizontal wrinkles could be a "red flag" indicating hardening of the arteries - a major trigger for heart attacks. They said GPs should keep a closer eye on those who look older than their years, and ensure they undergo a health MOT.
The French study tracked the health of more than 3,200 working adults - after classifying them into three groups, depending on the number and depth of horizontal wrinkles on their brows. A score of zero meant a smooth brow, while a score of three indicated "numerous deep wrinkles."
Twenty years later, 2.1 per cent of those with the smoothest skin had died - rising to 15.2 per cent of those with the most wrinkles. When adjusted to take account of other factors - such as smoking, age, and health conditions - it amounted to a 10-fold difference in premature mortality.
Yolande Esquirol, the lead researcher and associate professor of occupational health at the Centre Hospitalier Universitaire de Toulouse, said the study was the first to establish a link between cardiovascular risk and forehead wrinkles.
Speaking at the European Society of Cardiology conference in Munich, she said: "We explored forehead wrinkles as a marker because it's so simple and visual. Just looking at a person's face could sound an alarm, then we could give advice to lower risk. The higher your wrinkle score, the more your cardiovascular mortality risk increases."
Researchers said deep wrinkles could indicate atherosclerosis, a hardening of the arteries due to a build-up of fatty plaques. Because blood vessels in the forehead are small, they could be sensitive to plaque build-up, they said.
Dr Esquirol said patients with deep wrinkles should be targeted for checks on cholesterol and blood pressure.
Professor Jean Ferrieres, a fellow researcher from Toulouse University School of Medicine, said a wrinkly forehead was a better predictor of heart trouble than high cholesterol.
He said: "This is more precise than cholesterol levels, as it is a sign blood vessels are already being damaged."
Professor Jeremy Pearson, associate medical director at the British Heart Foundation, said: "Perhaps wrinkles can tell us more than we think about our heart health, but counting lines won't replace tests for well-understood risk factors, such as high cholesterol and blood pressure."
Previous research examining crow's feet - wrinkles around the eyes - found no link to heart risks.
Professor Kamila Hawthorne, the vice-chairman of the Royal College of GPs, said the findings were "interesting". She said: "Any research that seeks to aid better identification or treatment of heart disease, and further our understanding of the condition, is welcome, however strange the connection may seem."