The Occurrence of Raynaud's Phenomenon in a General Population: The Framingham Study

Abstract

The prevalence and predisposing conditions for primary and secondary Raynaud's phenomenon (RP) were examined in The Framingham Study based on 16 years of follow-up of a cohort of 4182 men and women. The association with atypical chest pain and migraine headache was also investigated.Over the 16 years of follow-up there were 130 men and 171 women who developed primary RP. The prevalence in women (9.6%) was somewhat higher than in men (8.1%) and 81.4% of the RP was primary. Secondary RP was equally prevalent in men (18.6%) and women (19.7%). The most common causes of secondary RP were beta-blocker use (34.2%), carpal tunnel syndrome (10.5%) and rheumatoid arthritis (7.2%).Primary RPcases differed from noncases by having lower systolic blood pressure (p ,,;;0.001) and diastolic blood pressure (p < 0.0001), and more coronary disease (p= 0.009), smoking (p « 0.01) and higher blood sugars (p,,;; 0.009).Atypical chest pain was present more often than noted previously in The Framingham Study general population survey, and was equally prevalent in primary and secondary RP and in the two sexes. Associated migraine was more prevalent in women (14.4%) than men (5.0%).Vibrating tool use with associated RP occurred in 14.6%.

Nerve conduction velocity study of the upper limb in Raynaud's phenomenon

“…Over the years, we have observed patients in whom RP was present before CTS, others in whom RP developed after CTS, and others who underwent surgical decompression of the median nerve which resolved the CTS but not the RP symptoms. Although CTS and RP are more frequent in the female sex, there is a dierent ratio between the sexes, 4:1 for CTS and 2:1 for RP, and a dierent age of onset, 50±60 years for CTS and 20± 40 years for RP [2,17,22]. Many of the above papers and the present clinical observations suggest that the association between idiopathic RP and CTS may be random.…”

“…In fact, the Framingham study of Boston, which had a follow-up of 16 years and a cohort of 4182 subjects, showed an association of 10.5% between RP and CTS in RP patients [2]. A French epidemiological study drew similar conclusions [3].…”

“…In forms secondary to connective tissue diseases or vibration trauma, alteration of acral vasomotor regulation may be associated with lesion of the peripheral nerves, especially the median nerve at the wrist [6,9,12,20]. Studies on a possible relation between RP, usually idiopathic, and carpal tunnel syndrome (CTS) have generally been epidemiological, clinical or angiological and have come to dierent, sometimes contrasting, conclusions [2,3,7,9,13,18]. No systematic electrophysiological study has been performed.…”

Anti-Hypertension Effect of Vanylidilol: A Phenylaldehyde α/β-Adrenoceptor Blocker with Endothelium-Dependent and K⁺ Channels Opening-Associated Vasorelaxant Activities

“…In contrast, the sustained depressor effect of vanylidilol may be related to its ß-adrenoceptor blocking action and other vasorelaxant mechanisms. The vasoconstrictor effect of tradi-tional ß-blockers, impairment of the peripheral circulation, including Raynaud's syndrome, often occurs during treatment [29]. Therefore, vanylidilol may have therapeutic efficacy advantages over propranolol [30].…”

Molecular Determinants of the Human α2C-Adrenergic Receptor Temperature-Sensitive Intracellular Traffic

“…These features define Raynaud's phenomenon, a disease described first by Maurice Raynaud in 1862 (Raynaud, 1862). Raynaud's phenomenon is regarded as a rare disease; however, it is in fact commonly encountered clinically and affects between 3 and 10% of the general population, with a higher incidence in women (Brand et al, 1997;Prete et al, 2014). Although Raynaud's phenomenon was described 150 years ago, a specific treatment is still missing today.…”