In incident SSc only, patient-reported worsening Raynaud’s phenomenon (OR 1.3, 95% CI 1.0–1.8, p = 0.05), raised CRP (OR 1.7, 95% CI 1.2–2.2, p < 0.01) and PAH (OR 1.8, 95% CI 1.2–2.9, p = 0.01) were associated with worsening of HAQ-DI scores, as were digital ulcers although not meeting statistical significance (OR 1.3, 95% CI 1.0–1.8, p = 0.08). The gene discussed is CRP; the disease is pulmonary arterial hypertension.