Plasma catecholamines during behavioral treatments for Raynaudʼs disease.

Freedman, R R; Keegan, D; Migály, P; Galloway, Matthew P.; Mayes, M

doi:10.1097/00006842-199107000-00008

Cited by 13 publications

(5 citation statements)

References 16 publications

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“…This theory is consistent with RP being the result of an intrinsic problem within the blood vessels and not a result of a systemic or humoral problem. 36 For example, levels of neither epinephrine nor norepinephrine are elevated in RP sufferers, 37 , 38 and it is possible to induce an RP episode in a digit that has its sympathetic nerve output blocked; 26 , 39 facts that both allude to vascular disorder.…”

Section: Discussionmentioning

confidence: 99%

Raynaud phenomenon and mortality: 20+ years of follow-up of the Charleston Heart Study cohort

Nietert¹,

Shaftman²,

Silver³

et al. 2015

CLEP

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BackgroundRaynaud phenomenon (RP) is a temporary vasoconstrictive condition that often manifests itself in the fingers in response to cold or stress. It often co-occurs with certain chronic diseases that impact mortality. Our objective was to determine whether RP has any independent association with survival.MethodsFrom 1987–1989, a total of 830 participants of the Charleston Heart Study cohort completed an in-person RP screening questionnaire. Two definitions of RP were used: a broad definition that included both blanching (pallor) and cyanotic color changes and a narrow definition that included only blanching. All-cause and cardiovascular disease (CVD) mortality were compared between subjects with and without RP using race-specific survival models that adjusted for age, sex, baseline CVD, and 10-year risk of coronary heart disease.ResultsUsing the narrow RP definition, we identified a significant interaction between older age and the presence of RP on all-cause mortality. In the broad RP definition model, the presence of RP was not associated with CVD mortality among blacks; however, among whites, the presence of RP was associated with a 1.6-fold increase in the hazard associated with CVD-related death (hazard ratio: 1.55, 95% confidence interval: 1.10–2.20, P=0.013).ConclusionRP was independently associated with mortality among older adults in our cohort. Among whites, RP was associated with increased CVD-related death. It is possible that RP may be a sign of undiagnosed vascular disease.

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Section: Discussionmentioning

confidence: 99%

Raynaud phenomenon and mortality: 20+ years of follow-up of the Charleston Heart Study cohort

Nietert¹,

Shaftman²,

Silver³

et al. 2015

CLEP

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“…However, sympathetic nervous input to various regions in the body tends to be highly differentiated (21), calling into question whether such hypothetical sympathetic changes with thermal feedback would indeed be generalized. Recent research on the physiological mechanisms underlying finger temperature warming indicates that a general reduction of sympathetic outflow, as measured by catecholamine levels, does not occur (22). In fact, skin conductance levels increase during temperature feedback (23), and there is evidence that finger warming is related to a non-neural beta-adrenergic mechanism (24,25).…”

Section: Discussionmentioning

confidence: 99%

Relaxation therapy for hypertension: setting-specific effects.

Rg¹,

Ap²,

O’Hara³

et al. 1992

Psychosomatic Medicine

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We determined the effect of relaxation therapy for hypertension in patients whose blood pressure remained elevated despite the use of antihypertensive medication. The effect was assessed in multiple settings, including the relaxation therapist's office, the Hypertension Clinic, and the patient's natural environment, the latter using 24-hour automated ambulatory blood pressure measures. Nineteen patients were randomized either to temperature biofeedback-assisted relaxation or to an attention control, "stress education." Antihypertensive medication was kept constant. In the behavioral therapist's office, blood pressure decreased in equivalent amounts with both treatments. Hypertension Clinic nurse blood pressure remained stable or increased with both treatments, but again there was no difference between treatments. Ambulatory blood pressure increased with relaxation therapy and decreased with stress education, the effect being significant for diastolic pressure. The effects on ambulatory blood pressure were limited to the waking hours. The only variable that showed superior effects for relaxation therapy was physician-determined blood pressure. These results call into question the generalizability of the effects of relaxation therapy from one setting to another.

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“…Results of laboratory studies 22,[25][26][27][45][46][47] of temperature biofeedback in control subjects show that tempera-ture biofeedback with instructions about warming can produce small but significant increases in skin temperature and blood flow, probably by promoting peripheral vasodilation. 12,45 Once learned, hand warming can be produced without feedback, 23,26 generalized to locations outside the laboratory, 23 and retained over time, 12,25,26 suggesting a robust effect that might be used to control RP symptoms. Published studies 20,27,48 provided initial support for this hypothesis.…”

Section: Commentmentioning

confidence: 99%

Comparison of Sustained-Release Nifedipine and Temperature Biofeedback for Treatment of Primary Raynaud Phenomenon

2000

Arch Intern Med

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Background:The efficacy and safety of sustainedrelease nifedipine for the treatment of primary Raynaud phenomenon (RP) has not previously been demonstrated by a randomized, controlled trial. Temperature biofeedback has been studied in patients with primary RP but not in a large multicenter controlled trial or compared with nifedipine therapy.Objective: To evaluate and compare the effectiveness of sustained-release nifedipine and temperature biofeedback for the treatment of primary RP.Participants and Methods: This is a randomized, controlled clinical trial, double-masked for drug and placebo but not masked for temperature and control biofeedback. It included 313 persons with primary RP as defined by medical history, physical examination findings, normal nailfold capillaries, and a history of 2 or more attacks per day during the previous cold season. Participants were randomized to 1 of 4 treatment groups: (1) sustained-release nifedipine, (2) pill placebo, (3) temperature biofeedback, or (4) control (electromyographic) biofeedback. The primary outcome measure was self-reported, color chart-verified RP attacks during 1 winter month approximately 1 year after initiation of treatment. Secondary outcome measures included verified attacks at 2 months, all attacks at 2 months and 1 year, and quality of life.

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Plasma catecholamines during behavioral treatments for Raynaudʼs disease.

Cited by 13 publications

References 16 publications

Raynaud phenomenon and mortality: 20+ years of follow-up of the Charleston Heart Study cohort

Raynaud phenomenon and mortality: 20+ years of follow-up of the Charleston Heart Study cohort

Relaxation therapy for hypertension: setting-specific effects.

Comparison of Sustained-Release Nifedipine and Temperature Biofeedback for Treatment of Primary Raynaud Phenomenon

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