Doctors are being urged to reassess the widespread use of Pregabalin, a painkiller prescribed to millions, following alarming new research that links it to a significantly increased risk of heart failure. This anti-seizure drug, commonly used for chronic nerve pain, anxiety, and epilepsy, was associated with a 48 percent increased risk of developing heart failure. The risk escalates even further for patients with a pre-existing history of heart disease, where taking Pregabalin raised the risk of heart failure by a staggering 85 percent compared to those prescribed Gabapentin, a similar drug used for chronic pain management.

Researchers are now emphasizing the critical need for clinicians to carefully weigh cardiovascular risks before prescribing Pregabalin, particularly for older or otherwise vulnerable patients. Chronic pain affects a substantial portion of adults over 65, and Pregabalin is a common treatment, functioning by blocking pain signals in the brain and spinal cord. While the NHS already lists potential side effects such as hallucinations, blood in the urine, and weight gain, experts are now underscoring that heart health must also be a serious consideration.

The Columbia University Irving Medical Center’s study, which analyzed data from 246,237 Medicare patients aged 65 to 89 over a four-year period, revealed these concerning findings. All participants had chronic non-cancer pain and no prior history of heart failure. Heart failure, a long-term condition where the heart is too weak or stiff to pump blood effectively, is more common in older individuals and often seen in heart attack survivors. During the study period, 1,470 patients were hospitalized with heart failure. Researchers found that for every 1,000 people taking Pregabalin, there were approximately six additional cases of heart failure annually, compared to those not on the drug.

After adjusting for various factors like age, sex, and pre-existing health issues, the study concluded that patients taking Pregabalin are 1.5 times more likely to suffer heart failure. Heart failure, which usually worsens over time, is not a condition where the heart stops beating but one where it requires support to function better, causing symptoms like breathlessness, fatigue, syncope, swollen ankles, and sometimes a persistent cough and faster heart rate. There is currently no cure, though it can be managed. Dr. Elizabeth Park, who led the research, stated that their findings support the European Medicines Agency's existing advice to exercise caution when prescribing Pregabalin to older adults with heart disease.

Prominent cardiologist Dr. Robert Zhang, not involved in the study, commented that the findings have “immediate clinical implications,” stressing that clinicians must “weigh the potential cardiovascular risks associated with Pregabalin against its benefits.” Experts highlight the timeliness of these findings given the drug’s increasing use among older populations for chronic pain management. They suggest that if Pregabalin use is linked to new-onset heart failure, it could potentially unmask underlying heart disease, necessitating careful cardiac evaluation before prescription. This study serves as a crucial reminder that not all gabapentinoids are alike, and vigilance for unintended harms remains paramount in the pursuit of safer pain control.

These medical insights come at a time when national heart health in the UK is reportedly declining faster than in any other decade for over 50 years. Analysis by the British Heart Foundation indicates rising deaths from cardiovascular disease among working-age adults, an increase in heart failure cases, and growing risks associated with obesity and diabetes. Specifically, cardiovascular deaths in working-age adults in the UK have risen by 18 percent since 2019, from 18,693 to 21,975 in 2023, averaging 420 deaths per week.