Beta-blockers in the prevention of gastrointestinal bleeding.
Betablockers were introduced in Hepatology 10 years ago as vasoactive drugs to reduce portal pressure. Utilization to prevent recurrent gastrointestinal bleeding in patients with portal hypertension has been widely evaluated through the years. More recently, this approach has been used to prevent a first variceal bleeding episode. Meta-analysis evaluation of 5 large controlled trials shows that with P-blockers, first hemorrhagic episode ocurred in 10% verus 30% which ocurred with placebo after one year. Re-bleeding episodes with beta-blockers ocurred in 44% of the patients after 2 years of followup and in 65% of patients receiving placebo.
Lebrec
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Laboratoire d'Hémodynamique Splanchnique, Unité de Recherches de Physiopathlogie Hépatique (INSERM U-24), Hopital Beaujon, Clichy, France.
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D004932:Esophageal and Gastric Varices / Q000150:complications; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000188:drug therapy*; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D015201:Meta-Analysis as Topic; D011433:Propranolol / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012008:Recurrence
D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D011433:Propranolol