0672 Treatment of Restless Legs Syndrome Lowers Increased RLS - Related Cardiovascular Risk

Abstract

Introduction: Previous studies regarding restless legs syndrome (RLS) and future risk of cardiovascular disease (CVD) generated inconsistent results. Whether RLS treatment is associated with altered subsequent CVD risk has not been studied. Methods: This prospective cohort study was based on the 2006-2014 Truven MarketScan data. The study sample included 24,199 non-pregnant participants with RLS diagnosis (16,694 receiving RLS related treatment and 7,505 without treatment) during 2006-2008 and 145,194 age and sex matched participants without RLS. All participants were free of CVD before January 1st, 2009 (analysis baseline). Incident CVD cases (myocardial infarction, angina, stroke, atrial fibrillation, and heart failure) were identified. A Cox proportional hazards model was used adjusting for age, sex, residence, alcohol consumption, obesity, presence of chronic obstructive pulmonary disease (a surrogate for smoking status), depression, obstructive sleep apnea, insomnia, diabetes, hypertension, peripheral neuropathy, arthritis, iron deficiency anemia, Parkinson disease, and chronic kidney disease, and use of antiplatelets, anticoagulants, statins, antihypertensive and hypoglycemic treatments. Results: We identified 16,574 incident CVD cases during 2009 t0 2014. Presence of RLS at the baseline was associated with higher risk of developing CVD. Relative to the non-RLS group, the adjusted HR was 1.26 (95% CI 1.20, 1.32) for the RLS with treatment, and 1.53 (95%CI: 1.42, 1.65) for the RLS without treatment, after adjusting for aforementioned covariates. Significant lower CVD risk was observed for all different RLS treatments (dopaminergics, anticonvulsants, benzodiazepines or opiates; adjusted HR ranged 0.71 to 0.84; P<0.001 for all), except for ergot-dopamine use (adjusted HR=1.01; 95% CI 0.48, 2.15). Results were similar and statistically significant when we excluded patients with sleep disorders, depression and other major chronic conditions. Conclusion: Physician-diagnosed RLS was associated with higher future CVD risk. Treating RLS alleviated this potential harmful impact. The wide variety of agents showing improvement of cardiovascular disease in RLS suggests that this effect is specific to the improvement of RLS.