Top Things to Know: Primary and Secondary Raynaud
Updated: August 25, 2026
Prepared by Guillaume Goudot, MD, PhD
- Raynaud phenomenon (RP) is a common vasospastic disorder causing transient digital ischemia triggered by cold or emotional stress.
- Distinguishing primary RP (PRP) from secondary RP (SRP) is essential, as prognosis and management differ significantly.
- PRP is a functional disorder. It involves exaggerated vasoconstriction and endothelial dysfunction without structural vascular damage.
- Secondary RP (SRP) is associated with structural vascular disease, including connective tissue disorders, thromboangiitis obliterans, and proximal or distal arterial occlusive processes.
- Clinical evaluation is key. Red flags include late onset, asymmetry, ischemic lesions, or systemic features.
- Nailfold videocapillaroscopy provides key morphological insights into microvascular damage, particularly in systemic sclerosis.
- Functional techniques such as Laser Doppler assess peripheral blood flow. They help quantify disease severity and treatment response.
- RP has a significant impact on quality of life. Symptoms affect daily activities and functional status.
- Patient-reported outcomes complement clinical evaluation. They capture symptom burden and treatment effects.
- Advances in imaging, including ultrasound-based microvascular techniques, offer new opportunities to detect early vascular alterations and refine diagnosis.
Citation
Ujueta F, Goudot G, Cutolo M, Dolan R, Hoffman C, Desai M, Gerhard-Herman M; on behalf of the American Heart Association Council on Peripheral Vascular Disease; Council on Cardiovascular and Stroke Nursing; and Council on Clinical Cardiology. Primary and secondary Raynaud: a scientific statement from the American Heart Association. Circulation. Published online August 25, 2026. doi: 10.1161/CIR.0000000000001464