The relationship between diagonal earlobe crease and coronary risk factors, controlling for age and sex effects, was tested in 686 persons. A positive correlation (rho=.86, P<.001) is obtained between age and percentage of persons with earlobe creases in each one-year age interval; no sex difference is seen. To test for associations between cardiovascular risk factors and earlobe creases, 67 persons with creases are compared with 67 controls (matched by age and sex) without creases, using the following variables: diastolic and systolic blood pressures, cigarette smoking, weight, height, scapular skinfold thickness, serum cholesterol level, high-density lipoprotein level, intracellular sodium, sodium-lithium countertransport, plasma renin level and the presence of diabetes and hypertension. None of these variables differs significantly between cases and controls, indicating that the previously documented association between earlobe crease and coronary heart disease may be independent of these risk factors. Although coronary heart disease has often been shown to aggregate in families, no familial aggregation is found for earlobe creases.