Beta-blockers in portal hypertension. An overview.

This paper describes a meta-analysis of data from the 5 primary and 15 secondary prevention studies in patients with portal hypertension, in which beta-blockers were compared with inactive control. These studies involved 1525 patients. Overall, the number of patients who suffered bleeding events was 38% lower in the groups treated with beta-blockers (p less than 0.001). The percentage reductions in bleeding-related deaths and in total mortality were 35% and 18%, respectively (p = 0.007 and p = 0.024). More detailed analysis supports the conclusion that propranolol, the beta-blocker predominantly used in these studies, is effective in both the primary and secondary prevention of bleeding events and mortality due to portal hypertension.