Pregabalin heart risk study

A large Medicare study finds pregabalin is associated with an increased risk of heart failure in adults aged 65 to 89, especially for those with prior heart disease.

Pregabalin linked to higher heart failure risk in older adults

A Columbia University Irving Medical Center study analyzed data from 246,237 Medicare patients aged 65 to 89 over four years to examine the cardiovascular safety of pregabalin, a widely used drug for nerve pain, anxiety and epilepsy. Researchers found a 48 percent higher risk of heart failure among pregabalin users compared with those taking gabapentin. Among patients with a history of heart disease, the risk rose to 85 percent. Across the cohort, about six additional cases of heart failure per year were seen for every 1,000 pregabalin users. There were 1,470 hospitalizations for heart failure during the study period. The findings echo ongoing safety cautions from the European Medicines Agency.

Pregabalin is prescribed when other pain treatments fail to provide relief. Side effects can include headaches, diarrhea, nausea, blurred vision and memory problems, and in rare cases anaphylaxis. The study authors emphasize cautious prescribing for older adults and those with heart disease, and they urge clinicians to review cardiovascular history before starting pregabalin and to monitor patients for heart-related symptoms. The study does not prove that pregabalin causes heart failure, but it shows a real association in a large real-world population that warrants careful consideration in daily practice.

The report highlights a persistent tension in medicine: how to balance meaningful nerve pain relief with potential cardiovascular risks. For many patients, pregabalin offers welcome relief, yet the data remind doctors that age and heart history can tilt the risk-benefit equation. The finding should push clinicians toward personalized care, including alternative therapies when appropriate and closer monitoring after initiation. As with many observational studies, unmeasured factors could influence results, so this should be interpreted as a signal rather than a final verdict.

Beyond individual prescribing, the results could influence labeling and guidelines, potentially nudging insurers and policymakers to tighten recommendations for older patients with heart disease. The broader takeaway is clear: patient safety must shape practice, even when a drug remains valuable for relief. Communication with patients about benefits and risks becomes essential in maintaining trust when new data emerge.

Highlights

Further study will clarify how to balance pain relief with heart health in aging populations.