From the FDA Drug Label
In short-term trials of patients without clinically significant heart or peripheral vascular disease, there was no apparent association between peripheral edema and cardiovascular complications such as hypertension or congestive heart failure Although weight gain was not associated with clinically important changes in blood pressure in short-term controlled studies, the long-term cardiovascular effects of pregabalin-associated weight gain are unknown.
The FDA drug label does not directly answer whether Lyrica (pregabalin) can cause hypertension. However, it mentions that there was no apparent association between peripheral edema and cardiovascular complications such as hypertension in short-term trials. Additionally, it states that weight gain was not associated with clinically important changes in blood pressure in short-term controlled studies, but the long-term cardiovascular effects of pregabalin-associated weight gain are unknown 1 1.
From the Research
Lyrica (pregabalin) can potentially cause hypertension in some patients, though it is not among the most common side effects. Blood pressure increases have been reported in clinical trials and post-marketing surveillance, with some patients experiencing new-onset hypertension or worsening of existing high blood pressure. The mechanism appears to be related to pregabalin's effects on the peripheral nervous system and possibly fluid retention, which can occur in approximately 1-2% of patients taking the medication, as seen in a study published in 2022 2. Patients with pre-existing cardiovascular conditions may be at higher risk for this side effect. If you're taking Lyrica and notice symptoms like headaches, dizziness, or visual changes, you should monitor your blood pressure and consult your healthcare provider. Regular blood pressure monitoring is advisable when starting pregabalin or adjusting the dose, particularly in patients with cardiovascular risk factors or history of hypertension. Your doctor may need to adjust your antihypertensive medications if significant blood pressure elevations occur while on Lyrica therapy. It's essential to consider the potential cardiovascular risks associated with pregabalin, including heart failure, myocardial infarction, peripheral vascular disease, stroke, deep venous thrombosis, and pulmonary embolism, as reported in the 2022 study 2. The management of hypertension is crucial, and lifestyle modifications, such as weight loss, healthy dietary patterns, physical activity, and moderation of alcohol consumption, can help lower blood pressure, as recommended in a 2022 review 3. Additionally, first-line antihypertensive medications, including thiazide or thiazide-like diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and calcium channel blockers, can be effective in lowering blood pressure and preventing cardiovascular disease outcomes, as discussed in a 2018 review 4. Overall, while Lyrica may cause hypertension in some patients, the benefits of the medication should be weighed against the potential risks, and regular monitoring and management of blood pressure are essential to minimize the risk of cardiovascular complications. The global epidemiology of hypertension highlights the importance of awareness, treatment, and control of hypertension to reduce the burden of cardiovascular disease, as reported in a 2020 study 5. In clinical practice, it's crucial to consider the individual patient's risk factors and medical history when prescribing pregabalin and to monitor their blood pressure regularly to minimize the risk of cardiovascular complications. The comparative effectiveness of antihypertensive medications should also be considered, as some medications may be more effective than others in reducing the risk of cardiovascular disease outcomes, as discussed in a 2012 review 6.