Is carvedilol or propranolol better in the treatment of Portal Hypertension?
Liver cirrhosis, commonly known as scarring of the liver, can lead to many complications like blockage of the blood flow through the liver or portal hypertension and also other complications like variceal bleeding and ascites. Portal hypertension can be due to increase in the hepatic portal pressure gradient (HVPG) and can lead to shunting of portal blood to systemic circulation. Studies have shown that by maintaining a HVPG to less than 12 mmHg or by 20% from the baseline value could significantly reduce the hemorrhage or bleeding (Aguilar-Olivos N). Non selective beta blocker like propranolol or carvedilol have been used most widely as the pharmacologic therapy in patients with cirrhosis and have shown to be effective in prevention of first and subsequent bleeding episodes. Even though Propranolol has been used most widely for portal…show more content… showed that short term administration of carvedilol was more powerful in comparison to propranolol in decreasing portal hypertension in cirrhosis patients. This study consisted of 51 patients who were randomly allocated to receive either carvedilol (n=26) or propranolol (n=25). The major outcome of this study was it showed a greater reduction in portal hypertension in patients with cirrhosis and esophageal varices while using carvedilol than propranolol with a p-value of <0.00001. The adverse events did not differ between the administrations of these two drugs but these differences in results might have been due to the specific dose differences of carvedilol and propranolol administration. Particularly in this study, higher doses of carvedilol were used which might have shown the statistically significant differences in the data (Aguilar-Olivos
