Beta-blockers and portal hypertension, hemodynamic effects and prevention of recurrent gastrointestinal bleeding.

It has been demonstrated that propranolol might reduce portal pressure by reducing cardiac output in patients with cirrhosis and it has thus been hypothesized that beta-blockers may be useful as pharmacological treatment for portal hypertension (1). Subsequently, further studies have detailed the systemic and splanchnic circulatory effects of beta-blockers in patients with portal hypertension and in different models of portal hypertension in animals, and several controlled studies have been performed. This article reviews the hemodynamic effects of beta-blockers in portal hypertension, and reports clinical trials on the prevention of recurrent gastrointestinal bleeding.