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Cardiovascular comorbidity in patients with restless legs syndrome: current perspectives

Authors Vargas-Pérez NJ, Bagai K, Walters AS

Received 7 August 2016

Accepted for publication 4 March 2017

Published 3 May 2017 Volume 2017:7 Pages 13—28


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Peter Hedera

Noel J Vargas-Pérez, Kanika Bagai, Arthur S Walters

Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA

Introduction: Restless legs syndrome (RLS) is a sensorimotor neurological disorder associated with poor quality of life. Growing evidence links RLS and periodic limb movement in sleep (PLMS) with increased risk of cardiovascular and cerebrovascular disease. This article reviews the association of RLS and PLMS with cardiovascular disease (CVD).
Methods: PubMed and Medline database (1990 to July 2016) were searched for the terms “restless legs,” “restless legs syndrome,” “periodic limb movements,” “periodic limb movements in sleep” cross-referenced with “cardiovascular disease,” “heart disease,” “coronary artery disease,” “coronary heart disease,” “heart arrhythmia,” “heart failure,” “congestive heart failure,” “echocardiogram,” “echocardiographic,” “hypertension,” “high blood pressure,” “cerebrovascular disease,” “stroke,” “autonomic nervous system,” “heart rate,” “heart rate variability,” “hypoxia,” “microcirculation,” “oxidative stress,” “inflammation,” “chronic kidney disease,” “end-stage renal disease,” “renal disease,” “hemodialysis,” “multiple sclerosis,” “Parkinson,” “Parkinson’s,” “iron deficiency anemia,” and “mortality.” Other relevant articles from the reference list of the above-matched manuscripts were also reviewed. Studies that did not specify the diagnostic criteria for RLS or manuscripts in languages other than English were excluded. Articles with emphasis in RLS secondary to pregnancy were not included in this manuscript.
Results: Eighty-six original articles were included in this review. Although mixed results were found regarding the association of RLS and PLMS with CVD, hypertension, stroke and mortality, an informal review of the literature does suggest that the bulk of the evidence favors such an association.
Conclusion: The current evidence in general supports the association between RLS/PLMS and CVD. The variability of results likely represent differences in study designs, RLS criteria used, RLS severity, duration of disease, and time of follow-up between the studies. As the association between RLS/PLMS and CVD is not definitive at this time, further suggested studies are outlined.

Keywords: restless legs syndrome, periodic limb movements in sleep, cardiovascular disease, heart disease, hypertension, stroke, chronic kidney disease

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