title: Significant association between systolic and diastolic blood pressure elevations and periodic limb movements in patients with idiopathic restless legs syndrome.
abstract: OBJECTIVE
  A new and unique methodology was developed to evaluate the association between periodic limb movements (PLMs) and nocturnal blood pressure (BP) excursions in patients with restless legs syndrome (RLS).
  
  
  METHODS
  All data were collected at baseline of the ENCORE (Effects of Neupro on Cardiovascular Observations in Patients with Restless Legs Syndrome) study, a placebo-controlled polysomnographic study of rotigotine in patients with idiopathic RLS. Continuous beat-by-beat BP and heart rate assessments were performed during a full night of polysomnography. All BP elevations occurring with and without PLMs were systematically identified and analyzed.
  
  
  RESULTS
  Patients (n = 89) had a mean total of 508.9 ± 405.7 PLMs, 788.4 ± 261.9 systolic BP elevations, and 349.7 ± 242.9 diastolic BP elevations during the night. Higher time-adjusted frequencies of systolic BP elevations [mean difference (95% confidence interval, CI): 543.0 (487.2, I); p <0.0001] and diastolic BP elevations (205.8 (169.3, I); p <0.0001) were observed with PLMs than without PLMs. A peak in the frequency of PLM onset coincided with BP elevation onset.
  
  
  CONCLUSIONS
  Our methodology allowed the first evaluation of the total number of nocturnal PLM-associated BP elevations occurring in patients with RLS. Our data clearly indicate an interdependence between BP elevations and PLMs, and they have clinical relevance as BP variability is a potential cardiovascular risk factor.
authors: Philipps Universität Marburg, Marburg, Germany. Electronic address: cassel@med.uni-marburg.de.
authors: Werner
authors: W
authors: Cassel
authors: Philipps Universität Marburg, Marburg, Germany.
authors: Karl
authors: K
authors: Kesper
authors: Klinikum der Universität München, Department of Cardiology, and Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), München, Germany.
authors: Axel
authors: A
authors: Bauer
authors: UCB Pharma, Monheim am Rhein, Germany.
authors: Frank
authors: F
authors: Grieger
authors: UCB Pharma, Monheim am Rhein, Germany.
authors: Erwin
authors: E
authors: Schollmayer
authors: UCB Pharma, Monheim am Rhein, Germany.
authors: Lars
authors: L
authors: Joeres
authors: University Medical Center, Department of Neurosurgery, Göttingen and Paracelsus-Elena-Klinik, Kassel, Germany.
authors: Claudia
authors: C
authors: Trenkwalder
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D003971:Diastole; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020189:Nocturnal Myoclonus Syndrome / Q000503:physiopathology*; D017286:Polysomnography; D012148:Restless Legs Syndrome / Q000503:physiopathology*; D012307:Risk Factors; D013599:Systole; D055815:Young Adult
keywords: Blood pressure elevations; Periodic limb movements; Polysomnography; Restless legs syndrome