Beta-blockers and cirrhosis: Striking the right balance.
- Resource Type
- Academic Journal
- Authors
- Cromer M; Division of General Internal Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: markcromer@uabmc.edu.; Wilcox CM; Digestive Health Institute, Orlando Health, Orlando, FL, USA.; Shoreibah M; Division of Gastroenterology & Hepatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
- Source
- Publisher: Elsevier Country of Publication: United States NLM ID: 0370506 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1538-2990 (Electronic) Linking ISSN: 00029629 NLM ISO Abbreviation: Am J Med Sci Subsets: MEDLINE
- Subject
- Language
- English
Decompensated cirrhosis is associated with a significantly increased risk of mortality. Variceal hemorrhage (VH) further increases the risk of mortality, and of future variceal bleed events. Non-selective beta-blockers (NSBBs) are effective therapy for primary and secondary prophylaxis of VH and have become the cornerstone of pharmacologic therapy in cirrhosis. Beta-blockers are associated with reduced overall mortality and GI-bleeding related mortality in patients with decompensated cirrhosis; they may also confer hemodynamically independent beneficial effects. Long-term treatment with beta-blockers may improve decompensation-free survival in compensated cirrhosis with clinically significant portal hypertension (CSPH). Carvedilol more effectively lowers the hepatic vein portal gradient than traditional NSBBs and has been shown to improve survival in compensated cirrhosis. Treatment goals in compensated cirrhosis with CSPH should focus on early utilization of beta-blockers to prevent decompensation and reduce mortality.
Competing Interests: Declaration of competing interest There are no conflicts of interest for any authors involved with this paper.
(Copyright © 2024 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.)