Carvedilol in the Treatment of Portal Hypertension
Variceal bleeding is a major event in the natural history of end-stage liver disease with a subsequent high mortality rate. Non-selective β-blockers are currently the drugs of choice for preventing first variceal bleeding. Endoscopic rubber band ligation of high risk varices features as a first line...
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| Format: | Online |
| Language: | English |
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Medknow Publications
2011
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| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3099066/ |
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pubmed-3099066 |
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pubmed-30990662011-05-23 Carvedilol in the Treatment of Portal Hypertension Al-Ghamdi, Hamdan New Horizon Variceal bleeding is a major event in the natural history of end-stage liver disease with a subsequent high mortality rate. Non-selective β-blockers are currently the drugs of choice for preventing first variceal bleeding. Endoscopic rubber band ligation of high risk varices features as a first line option if cirrhotic patients cannot tolerate β-blockers. Despite adequate β-blockade, some patients may still present with variceal bleeding. The effect of carvedilol, a non-selective β and α-1 receptor-blocker, on lowering portal pressure has been investigated in several clinical trials and found to be superior to propranolol in both acute and chronic hemodynamic studies. Recently, carvedilol has also been compared with band ligation for primary prophylaxis against variceal bleeding with equivalent results to band ligation. Patient tolerance to carvedilol in advanced liver disease remains a source of concern. This review examines the place of carvedilol as an alternative to the currently recommended pharmacological therapy in prophylaxis against variceal bleeding. Medknow Publications 2011 /pmc/articles/PMC3099066/ /pubmed/21372358 http://dx.doi.org/10.4103/1319-3767.77251 Text en © Saudi Journal of Gastroenterology http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| repository_type |
Open Access Journal |
| institution_category |
Foreign Institution |
| institution |
US National Center for Biotechnology Information |
| building |
NCBI PubMed |
| collection |
Online Access |
| language |
English |
| format |
Online |
| author |
Al-Ghamdi, Hamdan |
| spellingShingle |
Al-Ghamdi, Hamdan Carvedilol in the Treatment of Portal Hypertension |
| author_facet |
Al-Ghamdi, Hamdan |
| author_sort |
Al-Ghamdi, Hamdan |
| title |
Carvedilol in the Treatment of Portal Hypertension |
| title_short |
Carvedilol in the Treatment of Portal Hypertension |
| title_full |
Carvedilol in the Treatment of Portal Hypertension |
| title_fullStr |
Carvedilol in the Treatment of Portal Hypertension |
| title_full_unstemmed |
Carvedilol in the Treatment of Portal Hypertension |
| title_sort |
carvedilol in the treatment of portal hypertension |
| description |
Variceal bleeding is a major event in the natural history of end-stage liver disease with a subsequent high mortality rate. Non-selective β-blockers are currently the drugs of choice for preventing first variceal bleeding. Endoscopic rubber band ligation of high risk varices features as a first line option if cirrhotic patients cannot tolerate β-blockers. Despite adequate β-blockade, some patients may still present with variceal bleeding. The effect of carvedilol, a non-selective β and α-1 receptor-blocker, on lowering portal pressure has been investigated in several clinical trials and found to be superior to propranolol in both acute and chronic hemodynamic studies. Recently, carvedilol has also been compared with band ligation for primary prophylaxis against variceal bleeding with equivalent results to band ligation. Patient tolerance to carvedilol in advanced liver disease remains a source of concern. This review examines the place of carvedilol as an alternative to the currently recommended pharmacological therapy in prophylaxis against variceal bleeding. |
| publisher |
Medknow Publications |
| publishDate |
2011 |
| url |
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3099066/ |
| _version_ |
1611454968498225152 |