Smoking, Alcohol and Raynaud's

Raynaud’s phenomenon is characterized by a narrowing of the blood vessels (called vasoconstriction) to the extremities, usually to the hands. When blood vessels close down, fingers become cold and white, then blue, and numb or painful. When the vessels open back up (called vasodilation), the hands become red or purple. Raynaud’s is often associated with connective tissue diseases, notably scleroderma, but when it occurs independently of other conditions, it is called primary Raynaud’s phenomenon.

What Problem Was Studied?

Although smoking impairs vasodilation, moderate alcohol consumption may counteract the blood vessel damage associated with smoking. Scientists have investigated possible associations between Raynaud’s, smoking, and alcohol consumption, but methodologic problems and small sample sizes have limited the accuracy and usefulness of those studies. A team of scientists from New England-area centers sought to determine whether smoking and alcohol were associated with primary Raynaud’s phenomenon in a large cross-sectional analysis of a middle-aged population.

What Was Done in the Study?

The research team, including Arthritis Foundation-funded scientists Lisa G. Suter, MD, and Liana Fraenkel, MD, MPH, from the VA Connecticut Healthcare System in West Haven, Conn., and Yale University School of Medicine in New Haven, Conn., conducted a study using data collected from the Framingham Offspring Study. To be included in the study, participants could not have an occupation that included vibratory tool use (which may affect blood vessel constriction), nor could they have clinical or laboratory findings consistent with an underlying connective tissue disease (such as scleroderma, lupus or rheumatoid arthritis).

Information that had been collected as part of the Framingham Offspring Study was gathered and analyzed. The research team looked for connections between smoking, alcohol consumption and the presence of Raynaud’s.

What Were the Study Results?

Scientists found no relationship between smoking and Raynaud’s in women, but they did find a correlation for men. Men who were current smokers had 2.5 times the risk of having Raynaud’s than men who had never smoked. After adjusting for confounding factors, current smoking remained independently associated with Raynaud’s among men.

Heavy alcohol consumption in women was associated with increased Raynaud’s prevalence. However, women who drank red wine had a lower prevalence than those who did not drink at all. After adjusting for confounders, heavy alcohol consumption was independently associated with increased odds of Raynaud’s among women and red wine consumption was still associated with reduced odds of Raynaud’s.

Men who drank red wine also had a lower prevalence of the condition than those who did not. Moderate alcohol or red wine consumption retained its protective effect after adjusting for other variables. However, smoking negated the positive effects of moderate red wine consumption in men.

What Does This Mean to People With Raynaud’s?

The study authors conclude, “Our data suggest that middle-aged women and men have distinct physiologic mechanisms underlying their Raynaud’s and, thus, may need sex-specific therapeutic approaches. Our data also support the possibility that moderate red wine consumption may protect against Raynaud’s and offer a focus for future research.”

Suter LG, Murabito JM, Felson DT, Fraenkel L. Smoking, alcohol consumption, and Raynaud’s phenomenon in middle age. Am J Med 2007;120:264-71. DOI: 10.1016/j.amjmed.2006.06.007.

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