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Evaluation of treatment efficacy of Raynaud phenomenon by digital blood pressure response to cooling

Department of Medicine, Medical University of South Carolina, SC, USA

J Richard Jennings

Department of Psychiatry and Psychology, University of Pittsburgh, PA, USA

Ivo Valter

Department of Medicine, Medical University of South Carolina, SC, USA

Margaret Frederick

Clinical Trials and Surveys Corporation, Baltimore, MD, USA

Bruce Thompson

Clinical Trials and Surveys Corporation, Baltimore, MD, USA

Edwin A Smith

Department of Medicine, Medical University of South Carolina, SC, USA

Robin Hill

National Heart, Lung, and Blood Institute, Bethesda, MD, USA

Raynaud's Treatment Study Investigators

Our previous studies have suggested that digital blood pressure response to cooling could provide a measure of the efficacy of treatments that are administered to patients with Raynaud phenomenon (RP). This method was used on 158 primary RP patients participating in a multicenter, randomized clinical trial that compared the efficacy of sustained-release nifedi-pine with temperature biofeedback in the treatment of RP. A pill placebo and electromyography served as controls. The response to local finger cooling was measured at 30°,20°,15° and 10°C in a temperature-controlled room under standardized conditions.

The results showed that, at the 15°C and 10°C local cooling temperatures, the patients in the nifedipine group had a higher mean digital systolic blood pressure, a higher relative digital systolic blood pressure (RDSP), a smaller proportion of subjects with RDSP, 70% and a smaller proportion of subjects with a zero reopening pressure than the patients in the three other treatment groups. These results were statistically significant at 10°C, the nifedipine group being significantly different from all others (p, 0.05); no significant difference was found between the three other treatment groups.

Key Words: attack frequency • digital blood pressure • nifedipine • Raynaud phenomenon • treatment trial

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