Restless Leg Syndrome Doubles Risk of Cardiovascular Disease

Increased cardiovascular disease, when talked about in reference to restless leg syndrome, has been seen to be a common factor among the elderly in particular.

Now, news that Restless Leg Syndrome sufferers were twice as likely to have a stroke or heart disease in comparison to people without RLS. Additionally, risk is greatest in those with the most frequent and severe symptoms, according to research published in the January 1, 2008, issue of the journal Neurology.

The study [1] , involving 3,433 people, found people with RLS were more than twice as likely to have cardiovascular disease or cerebrovascular disease. Results remained the same after adjusting for age, sex, race, body mass index, diabetes, high blood pressure, high blood pressure medication, HDL/LDL cholesterol levels, and smoking.

Frequency a Factor

“The association of RLS with heart disease and stroke was strongest in those people who had RLS symptoms at least 16 times per month,” said study author John W. Winkelman, MD, PhD. “There was also an increased risk among people who said their RLS symptoms were severe compared to those with less bothersome symptoms.”

“In particular, most people with RLS have as many as 200 to 300 periodic leg movements per night of sleep and these leg movements are associated with substantial acute increases in both blood pressure and heart rate, which may, over the long term, produce cardiovascular or cerebrovascular disease.”

RLS and High Blood Pressure

A 2001 study monitored 10 patients with RLS and/or Periodic Leg Movement (PLM) that were until then untreated for their symptoms[2]. Each person spent the night in a sleep laboratory where their blood pressure was monitored for any changes that may occur. Before being added to the study, is was noted that none of the volunteers suffered any type of heart disease, hypertension or taking blood pressure medications.

It is reported that during RLS, blood pressures were seen to raise an average of 20 point for systolic readings and 11 points for diastolic readings. Focus is now being put on the effects of RLS, as other sleep disorders shown similar results leading to a theory that sleeplessness plays a major role in how our body works, particularly the heart.

“This repetitive rise in blood pressure during periodic leg movements could be harmful to the cardiovascular system, especially in severe cases of RLS, the elderly, and those with a long history of the disease,” lead author Paola Lanfranchi, MD, MSc. “Past studies have shown that significant blood pressure changes, as shown in our study, are associated with the development of vascular and heart damage. Furthermore, drastic blood pressure surges at night have been associated with a higher rate of stroke in the elderly.”

Elderly at Risk Most

The continuous rise and fall in blood pressure that occur during RLS or Periodic Leg Movement (PLM) can be harmful and increase the chances for developing cardiovascular disease, especially in the elderly, who seem to be those who are most vulnerable, especially if there is an existing condition involving the heart, in addition, the changes caused by any drastic surges in a persons blood pressure, especially at night, may also be related to the higher rate of strokes.

What is important after this study is treatment and how these patients may be helped in the future to relieve not only their RLS symptoms, but prevent any new or additional damage to the heart. Doctors are the most important link when looking for treatment, so sharing with them any conditions, when talking with them about RLS is vital. With this information they may be able to relieve the RLS symptoms along with maintaining a safe blood pressure.

An unfortunate issue in the treatment of RLS and its affects on the heart is the realization that many doctors do not see RLS as a serious health risk, in particular cardiologists. The symptoms are often seen as a mere case of discomfort, but as studies are being done and those with the disorder begin to speak out, all doctors will need to begin the process of listening to their patients when the talk about RLS or PLM and how it is affecting their lives.

Without knowledge, patients may not seek medical attention; in turn leave themselves open to further complications due to their RLS, including heart attack and stroke. These issues become even more risky when faced by a person who may also suffer from a vascular or heart disease, however, tests have shown that those with healthy system may face cardiovascular issues due to the rise and fall of their blood pressure during RLS or PLM episodes.

From the results of these tests and reports it is hoped for a further understanding on what medications may be helpful in treating RLS and lessen the effect of possibly worsening cardiovascular disease, or for some have become an issue they have not faced before.

References

      1. John W. Winkelman, MD, PhD, Eyal Shahar, MD, MPH, Imran Sharief, MD and Daniel J. Gottlieb, MD, MPH “Association of restless legs syndrome and cardiovascular disease in the Sleep Heart Health Study”, Neurology 2008;70:35-42

PMID: 18166705

2. M. H. Pennestri, BSc, J. Montplaisir, MD, PhD, R. Colombo, G. Lavigne, DMD and P. A. Lanfranchi, MD, MSc “Nocturnal blood pressure changes in patients with restless legs syndrome” Neurology 2007;68:1213-1218

Heart image by Wellcome Images. Creative Commons license