Beta blockers in portal hypertension--current status.

ABSTRACT

Pharmacotherapy of portal hypertension started with the use of intravenous vasopressin in the 1960s. However, the short half life of the drug and the non-availability of an oral preparation limited its use to acute variceal bleeding. It was two decades later that propranolol, a beta blocker was shown to decrease portal pressure. However, the usefulness of beta blockers in the treatment of recurrent variceal bleeding remains controversial with controlled trials showing both benefit and lack of benefit. This review is aimed to bring into perspective, current knowledge of the effect of beta blockers on the splanchnic circulation in man and animals, its clinical usefulness in portal hypertension and its place in the therapeutic armamentarium against portal hypertension.