title: Raynaud phenomenon and mortality: 20+ years of follow-up of the Charleston Heart Study cohort.
abstract: BACKGROUND
  Raynaud 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.
  
  
  METHODS
  From 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.
  
  
  RESULTS
  Using 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).
  
  
  CONCLUSIONS
  RP 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.
authors: Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
authors: Paul J
authors: PJ
authors: Nietert
authors: Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
authors: Stephanie R
authors: SR
authors: Shaftman
authors: Department of Medicine, Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, SC, USA.
authors: Richard M
authors: RM
authors: Silver
authors: Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
authors: Bethany J
authors: BJ
authors: Wolf
authors: Greenville Health System, Care Coordination Institute, Greenville, SC, USA.
authors: Brent M
authors: BM
authors: Egan
authors: Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
authors: Kelly J
authors: KJ
authors: Hunt
authors: Department of Medicine, Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, SC, USA.
authors: Edwin A
authors: EA
authors: Smith
keywords: Raynaud disease; cardiovascular diseases; cohort studies; survival analysis