title: Smoking, alcohol consumption, and Raynaud's phenomenon in middle age.
abstract: BACKGROUND
  Data suggest Raynaud's phenomenon shares risk factors with cardiovascular disease. Studies of smoking, alcohol consumption, and Raynaud's have produced conflicting results and were limited by small sample size and failure to adjust for confounders. Our objective was to determine whether smoking and alcohol are independently associated with Raynaud's in a large, community-based cohort.
  
  
  METHODS
  By using a validated survey to classify Raynaud's in the Framingham Heart Study Offspring Cohort, we performed sex-specific analyses of Raynaud's status by smoking and alcohol consumption in 1840 women and 1602 men. Multivariable logistic regression analyses were used to examine the relationship of Raynaud's to smoking and alcohol consumption.
  
  
  RESULTS
  Current smoking was not associated with Raynaud's in women but was associated with increased risk in men (adjusted odds ratio [OR] 2.59, 95% confidence interval [CI], 1.11-6.04). Heavy alcohol consumption in women was associated with increased risk of Raynaud's (adjusted OR 1.69, 95% CI, 1.02-2.82), whereas moderate alcohol consumption in men was associated with reduced risk (adjusted OR 0.51, 95% CI, 0.29-0.89). In both genders, red wine consumption was associated with a reduced risk of Raynaud's (adjusted OR 0.59, 95% CI, 0.36-0.96 in women and adjusted OR 0.30, 95% CI, 0.15-0.62 in men).
  
  
  CONCLUSIONS
  Our data suggest that middle-aged women and men may have distinct physiologic mechanisms underlying their Raynaud's, and thus sex-specific therapeutic approaches may be appropriate. Our data also support the possibility that moderate red wine consumption may protect against Raynaud's.
authors.affiliation: VA Connecticut Healthcare System, West Haven, Conn, USA. lisa.suter@yale.edu
authors.forename: Lisa G
authors.initials: LG
authors.lastname: Suter
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Murabito
authors.forename: David T
authors.initials: DT
authors.lastname: Felson
authors.forename: Liana
authors.initials: L
authors.lastname: Fraenkel
mesh_terms: D000367:Age Factors; D000428:Alcohol Drinking / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011928:Raynaud Disease / Q000175:diagnosis / Q000453:epidemiology*; D012720:Severity of Illness Index; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology