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Beta-Blockers for All … or Not

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Variceal Hemorrhage

Abstract

Nonselective beta-blockers are vasoconstrictors that decrease portal pressure by producing splanchnic vasoconstriction and reducing portal venous territory blood flow. The efficacy of beta-blockers in portal hypertension has been reported in clinical studies since 1980. They were first shown to be useful in the prevention of recurrent variceal bleeding then in the prevention of the first episode of bleeding. It was then suggested that by reducing portal pressure, beta-blockers could help prevent the development of varices in patients with cirrhosis and no varices. However, these results are controversial. Recently, several studies have shown that in addition to classic contraindications beta-blockers may be deleterious in patients with advanced liver disease especially in those with portopulmonary hypertension and refractory ascites who undergo large volume paracentesis.

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Authors and Affiliations

  1. Service d’Hepatologie, Hopital Beaujon, APHP, INSERM U773, Centre de Recherche Biomedicale Bichat-Beaujon, 100 Boulevard du General Leclerc, Clichy, 92110, France

    Laure Elkrief & Didier Lebrec

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  1. Laure Elkrief
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  2. Didier Lebrec
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Correspondence to Didier Lebrec .

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Editors and Affiliations

  1. Luigi Sacco University Hospital, University of Milan, Milan, Italy

    Roberto de Franchis

  2. Ospedale Universitario Luigi Sacco, Universitá degli Studi di Milano, UOC Gastroenterologia, Milano, Italy

    Alessandra Dell’Era

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Elkrief, L., Lebrec, D. (2014). Beta-Blockers for All … or Not. In: de Franchis, R., Dell’Era, A. (eds) Variceal Hemorrhage. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0002-2_6

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  • DOI: https://doi.org/10.1007/978-1-4939-0002-2_6

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