Objective: To evaluate whether symptoms of restless leg syndrome (RLS) predict incidence of atherosclerotic diseases and changes in carotid intima-media thickness (cIMT) after 3 years of follow-up.

Background: Several studies in different populations suggest that there is a link between RLS and atherosclerotic diseases, although the temporal direction of the association is yet unclear. We previously reported association between RLS symptoms and atherosclerotic disease at baseline in the Canadian Longitudinal study of Aging (CLSA). This cohort has now been followed for 3 years, allowing prospective analysis of RLS as a risk factor for new atherosclerotic disease.

Method: In this prospective study, exposure to RLS was assessed based on 4-item minimal criteria of RLS, with frequency­>3x/week. We identified incident atherosclerotic disorders, based on self-reported new diagnosis of cardiovascular, cerebrovascular, or peripheral vascular disorders. Measurement of cIMT was performed at the bifurcation of the common carotid artery, and changes of cIMT after 3 years were compared between RLS and control groups. cIMT≥1mm was considered abnormal. To compare the predictive role of RLS for development of atherosclerotic disorders, we performed linear and logistic regression analysis, adjusted for age and sex.

Results: Among the 27,209 participants of CLSA who provided follow-up data, 2,155 reported symptoms of RLS (60.6% female, age=63.7±10 years) and 16,350 reported no RLS symptoms (47.5% female, age=62.22±10 years). After 3-year follow-up, RLS patients had a 2-fold higher risk of developing new cardiovascular disorder (4.0% vs. 2.1%, Adjusted OR[95%CI]=2.00[1.50,2.66]), and were 58% more likely to develop new cerebrovascular disorders (2.4% vs. 1.5%, AOR=1.57[1.14,2.16]). New peripheral vascular disorders developed in 5.6% of RLS patients, compared to 1.9% in controls. However, changes in the size of cIMT were not statistically different between RLS and control groups (0.055±0.17 vs. 0.054±0.15), adjusted mean difference[95%CI]=0.00[-0.01,0.01]). Development of new abnormal IMT was observed in 8.1% of RLS patients vs. 6.9% of controls (AOR=1.18[0.95,1.47]). In sensitivity analysis, excluding potential mimics of RLS (diabetes, and renal failure) similar results were observed.

Conclusion: RLS is associated with an increased risk of developing atherosclerotic disorders.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/restless-leg-syndrome-and-atherosclerosis-prospective-study-in-the-canadian-longitudinal-study-on-aging/