Toenails point to heart disease

NewsBot · Jun 6, 2008

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The BBC are reporting:
Toenails point to heart disease

Measuring the nicotine content in toenail clippings can help predict a woman's heart disease risk, a US study in nurses suggests.

Analysis of toenails from more than 62,500 women showed double the level of nicotine in those with heart disease than those without the condition.

The researchers said the test may be more accurate than simply asking a person about their smoking history.

It is well established that smokers have a higher risk of heart disease.

There are existing tests for the presence of nicotine in the body, for example testing the amount of nicotine breakdown products in saliva or urine, but they only reflect recent exposure to cigarette smoke.

Men and women who smoke are around twice as likely to suffer a heart attack in their life time as those who don't, and quitting smoking is one of the most effective ways to reduce this risk

Ellen Mason, cardiac nurse

Study leader, Dr Wael Al-Delaimy said because toenails grow slowly - at a rate of around 1cm a year - they may offer a longer-term estimate of a person's total exposure to tobacco smoke.

And would take into account exposure to passive smoking and smoking habits such as how much smoke a person inhales with each puff. ...
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NewsBot · Jun 6, 2008

Toenail Nicotine Levels as Predictors of Coronary Heart Disease among WomenWael K. Al-Delaimy, Meir J. Stampfer, JoAnn E. Manson and Walter C. Willett
American Journal of Epidemiology 2008 167(11):1342-1348

The authors assess the ability of toenail nicotine levels as a biomarker to predict incident coronary heart disease (CHD). A nested case-control study was carried out among 62,641 women aged 36–61 years in the Nurses' Health Study cohort who provided toenail clippings in 1982. Between 1984 and 1998, 905 incident CHD cases were diagnosed and matched with two controls by age and date of toenail collection. Using multivariate logistic regression analyses, the authors found a statistically significant dose-response association between increasing toenail nicotine levels and risk of CHD (ptrend < 0.0001); women in the highest quintile had a relative risk of 3.44 (95% confidence interval (CI): 2.56, 4.62) compared with women in the lowest quintile. With each increase in the log-transformed unit of continuous toenail nicotine levels, there was a 42% increase in the risk of CHD (relative risk = 1.42, 95% CI: 1.33, 1.52). The association remained significant when the number of cigarettes smoked and passive smoking were included as covariates (relative risk = 1.12, 95% CI: 1.01, 1.24). In conclusion, toenail nicotine levels are predictive of CHD among women independent of other risk factors and remained significant even after adjustment for history of cigarette smoking.
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NewsBot · Oct 10, 2009

"Capillary band width", the "nail (band) sign": a clinical marker of microvascular integrity, inflammation, cognition and age. A personal viewpoint and hypothesis.
Myers JB.
J Neurol Sci. 2009 Aug 15;283(1-2):86-90.

The nail provides a window of a person's wellbeing and the "nail (band) sign" provides an opportunity for the clinician to conveniently posit the state of the microcirculation of a person. Changes noted in the "capillary band" include splinter haemorrhages as an acute phenomenon. Changes in capillary band "width" and "prominence" indicate chronicity. "Capillary band width" and "prominence" may permit the differentiation of Alzheimer's from vascular causes of cognitive decline. Splinter haemorrhages and onycholysis alert clinicians to the presence of periodontal disease, and provide an indication of end organ "risk". "Capillary band width" widening and prominence is seen in chronic smokers. Nail changes not only reflect generalised disease or inflammation but also localised peripheral conditions that affect the microcirculation. The fourth finger on the left or right hand is usually used, or the middle finger, to measure "band width", but all fingers show the sign which is also present in the toes. Examination of "band width" and "prominence" together with other "nail signs" of wellbeing, such as the presence of the lunule at the base of the nail and smoothness of the convexity of the nail bed at its distal edge beneath the nail permit wellness evaluation and can be incorporated into standard medical practice before blood pressure measurement as a fundamental part of the clinical examination. Further evaluation will establish its importance as the most convenient yet reliable clinical sign of microvascular integrity and together with other nail signs determine its value in assessing wellness, as well as being a pointer to the presence of microvascular disease in investigative and epidemiological research and in patient management.
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