Neurology: Restless leg syndrome linked with heart problems

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Restless legs syndrome (RLS) is associated with prevalent coronary artery disease and cardiovascular disease, and the association appears stronger in those with greater frequency or severity of RLS symptoms, according to a study published in the Jan. 1 issue of Neurology.

John W. Winkelman, MD, PhD, from the division of sleep medicine at Brigham & Women's Hospital and Harvard Medical School in Boston, and colleagues, evaluated the cross-sectional association between RLS and prevalent cardiovascular disease (CVD) in a large community-based sample of middle-aged and elderly subjects.

The researchers undertook a cross-sectional observational study of 1,559 men and 1,874 women (mean age of 67.9 years) who were enrolled in the Sleep Heart Health Study, a community-based study of the cardiovascular consequences of sleep-disordered breathing. RLS was defined by positive responses on a self-administered questionnaire to the four diagnostic criteria, with symptoms occurring at least five times per month and associated with at least moderate distress. Coronary artery disease (CAD) was determined by self-report of doctor-diagnosed angina, myocardial infarction, or coronary revascularization procedure. Total CVD included CAD or history of physician-diagnosed stroke or heart failure. The relation of RLS to prevalent CAD and CVD was examined by multivariable logistic regression models.

RLS is a neurological disorder characterized by restlessness and a need to move one’s legs. Symptoms start or become worse when at rest. The symptoms occur mainly at night and can interfere with sleep. Some 5 percent to 10 percent of the adult population suffers from the syndrome, according to the study.

The authors found that RLS was present in 6.8 percent of women (128) and 3.3 percent of men (51). After adjustment for age, sex, race, body mass index, diabetes mellitus, systolic blood pressure, antihypertensive medication use, total high-density lipoprotein cholesterol ratio and smoking history, the ORs for CAD were 2.05 (1.38 to 3.04) and for CVD were 2.07 (1.43 to 3) for subjects with RLS compared to those without RLS, the authors wrote. The associations of RLS with CAD and CVD were stronger in those with RLS symptoms at least 16 times per month and were stronger in those with severe than in those with moderately bothersome symptoms. 

They found that the risk is greatest in people with the most frequent and most severe symptoms of RLS.

The study was supported by the National Heart, Lung and Blood Institute in cooperative agreements and research grants from 10 U.S. universities.