BACKGROUND: Willis-Ekbom disease (WED), also called restless legs syndrome 
(RLS), is a neurologic sensorimotor disease that may be associated with 
cardiovascular disease. Given high morbidity and mortality rates of 
cardiovascular disease worldwide, we assessed the relation between WED/RLS and 
cardiovascular health risks in a native South American population. We 
prospectively analyzed data from The Atahualpa Project of Ecuadorian adults aged 
40 years and older. Physicians interviewed consented persons on the health 
behavior and health factors of the American Heart Association (AHA) for ideal 
cardiovascular health in adults and underwent fasting laboratory blood 
collection and blood pressure evaluation. Certified neurologists conducted 
face-to-face interviews using the International Restless Legs Syndrome Study 
Group (IRLSSG) field instrument. Persons testing positive for WED/RLS and 
age-and sex-matched controls underwent confirmatory physical examinations 
conducted by a neurologist and a sleep specialist to whom IRLSSG designation was 
blinded.
FINDINGS: Of 665 persons, 94 (14 %) tested positive in IRLSSG; 40 (6 %) had a 
diagnosis of WED/RLS after neurologic examination and interview. Patients with 
WED/RLS were younger (53.5 vs 59.9 years, P = .001), without significant 
differences in sex ratios. Among AHA risk factors, only obesity was 
significantly more prevalent among patients with WED/RLS (42.5 % vs 23.5 %, 
P = .01). However, after adjustment for confounders, body mass index was not 
significantly associated with WED/RLS.
CONCLUSIONS: In adult Amerindians, although obesity and body mass index were 
associated with WED/RLS on univariate analyses, the association was not present 
after adjustment for confounders. No other significant associations were found 
between WED/RLS and AHA cardiovascular metrics.