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Restless legs syndrome and risk of incident cardiovascular disease in women and men: prospective cohort study.

ABSTRACT: To evaluate the association between restless legs syndrome (RLS) and incident cardiovascular disease (CVD).Prospective cohort study.Women's Health Study (WHS) and Physicians' Health Study (PHS), USA.29?756 female health professionals aged ?45 years and 19?182 male physicians aged ?40 years at baseline.Main outcome was incidence of major CVD; secondary outcomes were first incidence of myocardial infarction, stroke, death due to CVD or coronary revascularisation.3487 (11.7%) women and 1373 (7.2%) men met International Restless Legs Study Group criteria for RLS. In the WHS 450 major CVD events occurred and 1064 major CVD events were confirmed in the PHS. In both cohorts, RLS was not associated with increased risk of major CVD, stroke, myocardial infarction, CVD death or coronary revascularisation. After adjustment for major vascular risk factors, the HRs (95% CI) for major CVD were 1.15 (0.88 to 1.50) in women and 1.01 (0.81 to 1.25) in men. Highest multivariable-adjusted HRs were 1.29 (0.91 to 1.82) for total stroke in women and 1.22 (0.87 to 1.70) for CVD death in men. Excluding participants with comorbidities potentially leading to RLS did not substantially change the effect estimates.In these large prospective studies of female and male health professionals, RLS was not associated with an increased risk of any incident CVD event. The data do not support the hypothesis that RLS is a marker of increased risk of vascular disease.

SUBMITTER: Winter AC

PROVIDER: S-EPMC3312075 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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Restless legs syndrome and risk of incident cardiovascular disease in women and men: prospective cohort study.

Winter Anke C AC Schürks Markus M Glynn Robert J RJ Buring Julie E JE Gaziano J Michael JM Berger Klaus K Kurth Tobias T

BMJ open 20120323 2

<h4>Objectives</h4>To evaluate the association between restless legs syndrome (RLS) and incident cardiovascular disease (CVD).<h4>Design</h4>Prospective cohort study.<h4>Setting</h4>Women's Health Study (WHS) and Physicians' Health Study (PHS), USA.<h4>Participants</h4>29 756 female health professionals aged ≥45 years and 19 182 male physicians aged ≥40 years at baseline.<h4>Main outcome measures</h4>Main outcome was incidence of major CVD; secondary outcomes were first incidence of myocardial i ...[more]

PMID: 22447047

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Project description:Restless legs syndrome is a common sleep disorder, but there is a paucity of large cohort studies examining the association of restless legs syndrome with clinical outcomes, including all-cause mortality, incident coronary heart disease, stroke and chronic kidney disease. From a nationally representative prospective cohort of over 3 million US veterans [93% male, median follow-up time of 8.1 years (interquartile range: 7.0-8.5 years)] with baseline estimated glomerular filtration rate ? 60 mL min(-1) 1.73 m(-2), a propensity-matched cohort of 7392 patients was created, and the association between incident restless legs syndrome and the following was examined: (1) all-cause mortality; (2) incident coronary heart disease; (3) incident strokes; and (4) incident chronic kidney disease defined as estimated glomerular filtration rate <60 mL min(-1) 1.73 m(-2). Associations were examined using Cox models. The mean ± SD age of the propensity-matched cohort at baseline was 59 ± 12 years; 89 and 8% of patients were white and black, respectively; 31% of the patients were diabetic; and the mean baseline estimated glomerular filtration rate was 83.9 ± 15.1 mL min(-1) 1.73 m(-2). Propensity matching resulted in a balanced cohort, with the disappearance in baseline differences in comorbidities. Compared with restless legs syndrome-negative patients, incident restless legs syndrome was associated with 88% higher mortality risk [hazard ratio and 95% confidence interval: 1.88 (1.70-2.08)], and almost four times higher risk of coronary heart disease and stroke [hazard ratio: 3.97 (3.26-4.84) and 3.89 (3.07-4.94), respectively]. The risk of incident chronic kidney disease was also significantly higher in incident restless legs syndrome patients [hazard ratio: 3.17 (2.74-3.66)] compared with restless legs syndrome-negative counterparts. In this large and contemporary cohort of US veterans, incident restless legs syndrome was associated with higher risk of mortality, incident coronary heart disease, stroke and chronic kidney disease.

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Restless legs syndrome and risk of incident cardiovascular disease in women and men: prospective cohort study.

Publications

Restless legs syndrome and risk of incident cardiovascular disease in women and men: prospective cohort study.

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