Beta-blockers and cirrhosis: Striking the right balance

Am J Med Sci. 2024 Jan 21:S0002-9629(24)00009-0. doi: 10.1016/j.amjms.2024.01.009. Online ahead of print.ABSTRACTDecompensated 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.PMID:38262558 | DOI:10.1016/j.amjms.2024.01.009
Source: The American Journal of the Medical Sciences - Category: General Medicine Authors: Source Type: research