Which of the following is a common issue in patients with scleroderma?

Pulmonary hypertension is a common issue in patients with scleroderma due to the disease's impact on the connective tissues, which can lead to vascular changes and increased pressure in the pulmonary arteries. As scleroderma progresses, it can cause damage to the small blood vessels in the lungs, contributing to the development of pulmonary hypertension. This condition is significant because it can lead to serious complications, including heart failure and reduced exercise capacity.

Other choices, while relevant in different contexts, do not specifically align with the typical complications of scleroderma. Hypotension is less frequently associated with the disease compared to hypertension, particularly pulmonary hypertension. Spastic quadriparesis is more characteristic of neurological conditions rather than scleroderma. Excessive fever is not a typical symptom of scleroderma, which generally presents with other systemic issues such as skin thickening and joint pain.