Abstract
Previous population-based studies evaluating the association between restless legs syndrome (RLS) and cardiovascular risk factors have showed inconsistent results, especially for the relationship between RLS and hypertension. We, therefore, aimed to meta-analyze to assess the association between RLS and hypertension. PubMed and Embase databases were systematically searched to identify eligible studies. Nine population-based cross-sectional studies were selected for inclusion, involving 102,408 individuals. Overall, the prevalence of hypertension in RLS subjects was higher than those without RLS (OR = 1.36, 95% CI, 1.18–1.57, P = 0.043). Our findings indicate that RLS is associated with increased blood pressure. More large-scale and prospective studies are warranted to further clarify the relationship and its potential mechanism.
Similar content being viewed by others
References
Allen RP, Picchietti DL, Garcia-Borreguero D et al (2014) Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria: history, rationale, description, and significance. Sleep Med 15:860–873
Tison F, Crochard A, Leger D, Bouee S, Lainey E et al (2005) Epidemiology of restless legs syndrome in French adults: a nationwide survey: the INSTANT study. Neurology 65:239–246
Alattar M, Harrington JJ, Mitchell CM, Sloane P (2007) Sleep problems in primary care: a North Carolina family practice research network (NC-FP-RN) study. J Am Board Fam Med 20:365–374
Shi Y, Yu H, Ding D, Yu P, Wu D, Hong Z (2015) Prevalence and risk factors of restless legs syndrome among Chinese adults in a rural community of Shanghai in China. PLoS One 10(3):e0121215
Tan EK, Seah A, See SJ, Lim E, Wong MC et al (2001) Restless legs syndrome in an Asian population: a study in Singapore. Mov Disord 16:577–579
Kim J, Choi C, Shin K, Yi H, Park M et al (2005) Prevalence of restless legs syndrome and associated factors in the Korean adult population: the Korean Health and Genome Study. Psychiatry Clin Neurosci 59:350–353
Berger K, Luedemann J, Trenkwalder C, John U, Kessler C (2004) Sex and the risk of restless legs syndrome in the general population. Arch Intern Med 164:196–202
Trenkwalder C, Allen R, Högl B, Paulus W, Winkelmann J (2016) Restless legs syndrome associated with major diseases: a systematic review and new concept. Neurology 86(14):1336–1343
Novak M, Winkelman JW, Unruh M (2015) Restless legs syndrome in patients with chronic kidney disease. Semin Nephrol 35(4):347–358
Sabic A, Sinanovic O, Sabic D, Galic G (2016) Restless legs syndrome in patients with hypertension and diabetes mellitus. Med Arch 70(2):116–118
Moccia M, Erro R, Picillo M, Santangelo G, Spina E et al (2016) A four-year longitudinal study on restless legs syndrome in Parkinson disease. Sleep 39(2):405–412
Ulfberg J, Nystrom B, Carter N, Edling C (2001) Prevalence of restless legs syndrome among men aged 18 to 64 years: an association with somatic disease and neuropsychiatric symptoms. Mov Disord 16:1159–1163
Batool-Anwar S, Malhotra A, Forman J, Winkelman J, Li Y, Gao X (2011) Restless legs syndrome and hypertension in middle-aged women. Hypertension 58:791–796
Winkelman JW, Shahar E, Sharief I, Gottlieb DJ (2008) Association of restless legs syndrome and cardiovascular disease in the Sleep Heart Health Study. Neurology 70:35–42
Winkelman JW, Finn L, Young T (2006) Prevalence and correlates of restless legs syndrome symptoms in the Wisconsin Sleep Cohort. Sleep Med 7:545–552
Juuti AK, Läär E, Rajala U et al (2010) Prevalence and associated factors of restless legs in a 57-year-old urban population in northern Finland. Acta Neurol Scand 122:63–69
Giannini G, Zanigni S, Melotti R, Gögele M, Provini F et al (2014) Association between restless legs syndrome and hypertension: a preliminary population-based study in South Tyrol, Italy. Eur J Neurol 21(1):72–78
Allen RP, Picchietti D, Hening WA et al (2003) Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med 4:101–119
Micha R, Wallace SK, Mozaffarian D (2010) Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis. Circulation 121:2271–2283
Shi Y, Liu P, Guan J, Lu Y, Su K (2015) Association between glaucoma and obstructive sleep apnea syndrome: a meta-analysis and systematic review. PLoS One 10(2):e0115625
Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50:1088–1101
Egger M, Smith GD, Schneider M et al (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315:629–634
Wesstrom J, Nilsson S, Sundstrom-Poromaa I, Ulfberg J (2008) Restless legs syndrome among women: prevalence, co-morbidity and possible relationship to menopause. Climacteric 11(5):422–428
Wali SO, Abaalkhail B (2015) Prevalence of restless legs syndrome and associated risk factors among middle-aged Saudi population. Ann Thorac Med 10(3):193–198
Ohayon MM, Roth T (2002) Prevalence of restless legs syndrome and periodic limb movement disorder in the general population. J Psychosom Res 53(1):547–554
Erden EC, Erden İ, Türker Y et al (2012) Incremental effects of restless legs syndrome on nocturnal blood pressure in hypertensive patients and normotensive individuals. Blood Press Monit 17:231–234
Gottlieb DJ, Yenokyan G, Newman AB, O'Connor GT, Punjabi NM et al (2010) Prospective study of obstructive sleep apnea and incident coronary heart disease and heart failure: the sleep heart health study. Circulation 122(4):352–360
Shah NA, Yaggi HK, Concato J, Mohsenin V (2010) Obstructive sleep apnea as a risk factor for coronary events or cardiovascular death. Sleep Breath 14(2):131–136
Yaggi HK, Concato J, Kernan WN, Lichtman JH, Brass LM, Mohsenin V (2005) Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 353(19):2034–2041
Peppard PE, Young T, Palta M, Skatrud J (2000) Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 342(19):1378–1384
Duran-Cantolla J, Aizpuru F, Martinez-Null C, Barbe-Illa F (2009) Obstructive sleep apnea/hypopnea and systemic hypertension. Sleep Med Rev 13(5):323–331
Marin JM, Agusti A, Villar I, Forner M, Nieto D, Carrizo SJ et al (2012) Association between treated and untreated obstructive sleep apnea and risk of hypertension. JAMA 307(20):2169–2176
Guillot M, Sforza E, Achour-Crawford E, Maudoux D, Saint-Martin M, Barthelemy JC et al (2013) Association between severe obstructive sleep apnea and incident arterial hypertension in the older people population. Sleep Med 14(9):838–842
Allen RP, Bharmal M, Calloway M (2011) Prevalence and disease burden of primary restless legs syndrome: results of a general population survey in the United States. Mov Disord 26:114–120
Earley CJ, Silber MH (2010) Restless legs syndrome: understanding its consequences and the need for better treatment. Sleep Med 11:807–815
Gangwisch JE, Heymsfield SB, Boden-Albala B, Buijs RM, Kreier F, Pickering TG, Rundle AG, Zammit GK, Malaspina D (2006) Short sleep duration as a risk factor for hypertension: analyses of the first National Health and Nutrition Examination Survey. Hypertension 47:833–839
Rye DB, Trotti LM (2012) Restless legs syndrome and periodic leg movements of sleep. Neurol Clin 30:1137–1166
Pennestri MH, Montplaisir J, Fradette L et al (2013) Blood pressure changes associated with periodic leg movements during sleep in healthy subjects. Sleep Med 14:555–561
Siddiqui F, Strus J, Ming X, Lee IA, Chokroverty S, Walters AS (2007) Rise of blood pressure with periodic limb movements in sleep and wakefulness. Clin Neurophysiol 118:1923–1930
Chen NH, Chuang LP, Yang CT et al (2010) The prevalence of restless legs syndrome in Taiwanese adults. Psychiatry Clin Neurosci 64:170–178
Acknowledgments
The authors thank Prof. Jianglong Tu for his advice about performing the statistical analysis and revision after reviewing the manuscript.
Author information
Authors and Affiliations
Contributions
Conceived and designed the experiments: HN, YS, HL, and JT. Performed the experiments: HN, YS, HL, YG, and TD. Analyzed the data: YS, HL, YG, and TD. Wrote the paper: NH, YS, HL, YG, and TD. Screened titles and abstracts of articles: YS and HL. Data extraction: YS, HL, and NH.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflicts of interest.
Rights and permissions
About this article
Cite this article
Shen, Y., Liu, H., Dai, T. et al. Association between restless legs syndrome and hypertension: a meta-analysis of nine population-based studies. Neurol Sci 39, 235–242 (2018). https://doi.org/10.1007/s10072-017-3182-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10072-017-3182-4