Doctors say the study highlights the difference between biological and chronological age.
"Looking old for your age marks poor cardiovascular health," said Dr. Anne Tybjaerg-Hansen of the University of Copenhagen in Denmark.
She led the study and gave results Tuesday at an American Heart Association conference in Los Angeles.
A small consolation: Wrinkles elsewhere on the face and gray hair seemed just ordinary consequences of aging and did not correlate with heart risks.
The research involved 11,000 Danish people and began in 1976. At the start, researchers documented their appearance, tallying crow's feet, wrinkles and other signs of age.
In the next 35 years, 3,400 participants developed heart disease (clogged arteries) and 1,700 suffered a heart attack.
The risk of these problems increased with each additional sign of aging present at the start of the study. This was true at all ages and among men and women, even after taking into account other factors such as family history of heart disease.
Those with three to four of these aging signs - receding hairline at the temples, baldness at the crown of the head, earlobe creases or yellowish fatty deposits around the eyelids - had a 57 percent greater risk for heart attack and a 39 percent greater risk for heart disease compared to people with none of these signs.
Having yellowish eyelid bumps, which could be signs of cholesterol buildup, conferred the most risk, researchers found. Baldness in men has been tied to heart risk before, possibly related to testosterone levels. They could only guess why earlobe creases might raise risk.
Dr. Kathy Magliato, a heart surgeon at St. John's Health Center in Santa Monica, Calif., said doctors need to pay more attention to signs literally staring them in the face.
"We're so rushed to put on a blood pressure cuff or put a stethoscope on the chest" that obvious, visible signs of risk are missed, she said.