Raynaud's attacks reacts to environmental temperature.

Date:

09-Apr-2001

Source

J Behav Med

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Raynaud's Disease has been around for over 100 years and yet we still have little information about what to do with it. An episode of Raynaud's typically begins when one or more of the digits appear white as the individual is exposed to a cold environment or touches a cold object. This changing of color of the skin is considered to be the phase when the blood supply to the digits becomes deficient. This is caused by vasospasms, or spasms of the blood vessels that lead to the affected area. After the discoloration, the sensation of cold and sometimes numbness follows. If the affected digit is again warmed, then the blood supply returns to the area. Sometimes this is painful and there is a throbbing sensation. This series of attacks are referred to as Raynaud's Phenomenon. The name changes to Raynaud's Disease when other causes of the symptoms are ruled out. Over 50 percent of people with Raynaud's phenomenon have Raynaud's disease.

Other causes of secondary Raynaud's phenomenon include atherosclerosis of the extremities (frequently seen in men over age 50), collagen vascular diseases, arterial occlusive diseases, pulmonary hypertension, neurogenic lesions such as carpal tunnel syndrome, and certain blood diseases. Women are affected about five times more often than men, and the age of presentation is usually between 20 and 40 years.1

Researchers recently hypothesized that stress and anxiety were related to Raynaud's attacks when the mild outside temperatures caused constriction of the blood vessels. They assumed that in warmer temperatures, higher stress and anxiety would be connected with more painful, frequent, and severe attacks. The study recruited 313 sufferers of primary Raynuad's Phenomenon (RP). They studied the average outdoor temperature, stress, anxiety, age, sex, and interactions with the temperature from anxiety or stress. The outcomes were tested in multiple linear regression models separately, and stress and anxiety were also tested in separate models. The study showed that stress was not a significant predictor of painful, severe, or frequent attacks of RP. Above 60 degrees, higher anxiety attacks were more frequent. Attacks of greater pain occurred at temperatures above 60 degrees and between 40 and 49.9 degrees.2

References

1. Creager MA, Dzau VJ. Vascular diseases of the extremities. In: Fauci AS, Braunwald E. Isselbacher KJ, et al, eds. Harrison’s Principles of Internal Medicine, 14th ed. New York: McGraw-Hill; 1998:1401-1402.
2. Brown KM, et al. The effects of stress, anxiety, and outdoor temperature on the frequency and severity of Raynaud's attacks: the Raynaud's Treatment Study. J Behav Med 2001 Apr;24(2):137-53.