Doctors have been urged to reassess the use of a painkiller prescribed to millions, after alarming new research linked it to a significantly increased risk of heart failure.
Pregabalin—an anti-seizure drug often used to treat chronic nerve pain, anxiety and epilepsy—was associated with a 48 per cent increased risk of developing heart failure, according to a major new study.
The risk was even greater in those with a history of heart disease.
In these patients, taking pregabalin raised the risk of heart failure by a staggering 85 per cent compared to those prescribed gabapentin—a similar drug used to manage chronic pain.
Researchers are now calling for clinicians to carefully weigh up cardiovascular risks before prescribing the drug, especially in older or vulnerable patients.
Chronic pain affects up to 30 per cent of adults over the age of 65, and pregabalin is commonly used to manage this by blocking pain signals travelling through the brain and spinal cord.
However, the NHS already lists a range of potential side effects for the drug—including hallucinations, blood in the urine and weight gain—and now experts are warning that heart health must also be taken into serious consideration.
Pregabalin is used to treat a number of health conditions including epilepsy, anxiety and chronic pain
The NHS also warns that pregabalin can, in rare cases, trigger a severe allergic reaction known as anaphylaxis—a medical emergency that requires immediate treatment.
Now, researchers at Columbia University Irving Medical Center say the drug may also contribute to—or worsen—heart failure, particularly in older individuals.
In the study, scientists analysed data from 246,237 Medicare patients aged 65 to 89 over a four-year period.
All had chronic non-cancer pain—defined as pain lasting more than 12 weeks or beyond the normal healing time—and none had a previous history of heart failure.
Heart failure occurs when the heart becomes too weak or stiff to pump blood effectively around the body.
It’s a long-term condition that is commonly seen in heart attack survivors, and is far more common in older people.
In the study, during the four-year period examined, 1,470 patients were admitted to hospital with heart failure.
Researchers found that for every 1,000 people taking pregabalin, there were around six additional cases of heart failure each year, compared with those not taking the drug.
Heart failure does not mean that the heart has stopped beating but that it needs some support to help work better. The condition cannot usually be cured but can be managed with lifestyle changes, medication and surgery
After adjusting for potential variables, including age, sex and pre-existing health issues, they concluded patients taking pregabalin are 1.5 times more likely to suffer heart failure.
Currently there is no cure for the condition which usually worsens over time causing breathlessness, fatigue, syncope, and swollen ankles and legs.
Some people also experience a persistent cough and a faster than usual heart rate.
The researchers, led by Dr Elizabeth Park, concluded that their findings support current advice from the European Medicines Agency to exercise caution when prescribing pregabalin to older adults with heart disease.
Dr Robert Zhang, a leading cardiologist who was not involved in the study, said the findings have ‘immediate clinical implications.’
Together with other experts in the field, he wrote: ‘Clinicians should weigh the potential cardiovascular risks associated with pregabalin against its benefits.’
Experts say the findings are timely given the growing use of the drug in older populations to manage chronic main.
They added: ‘If pregabalin use is associated with new-onset heart failure, it raises the possibility that the drug may unmask underlying heart disease, which suggests a need for careful cardiac evaluation prior to prescribing this medication.
‘The study serves as an important reminder that not all gabapentinoids are created equal and that in the pursuit of safer pain control, vigilance for unintended harms remains paramount.’
It comes as concerning figures suggest the nation’s heart health has declined more quickly at the start of the 202s than any other decade for more than 50 years.
Analysis by the British Heart Foundation (BHF) found rising deaths among working-age adults from cardiovascular disease, increasing heart failure and growing risks from obesity and diabetes.
Cardiovascular deaths in working age adults have risen by 18 per cent in the UK since 2019, from 18,693 to 21,975 in 2023, averaging 420 a week.
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