An evidence-based medicine approach to beta-blocker therapy in patients with cirrhosis

Am J Med. 2004 Jun 1;116(11):759-66. doi: 10.1016/j.amjmed.2004.03.006.


Disease management strategies have gained attention in recent years because of their potential to improve health-related quality of life and prevent excessive resource use. Despite recognition as an important cause of mortality, cirrhosis with portal hypertension has not been widely discussed as a condition amenable to planned care management. Given the effect of variceal hemorrhage as the most immediate life-threatening complication of portal hypertension, a number of high-quality controlled clinical trials have confirmed the efficacy of beta-blocker therapy for primary and secondary prophylaxis. Despite the existence of practice guidelines that incorporate this information, specific clinical scenarios that demand consideration for beta-blocker therapy have not been well described. In this article, a number of hypothetical patient-based cases drawn from the authors' experiences are utilized to illustrate these issues.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Adult
  • Esophageal and Gastric Varices / etiology
  • Esophageal and Gastric Varices / prevention & control*
  • Evidence-Based Medicine
  • Female
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / prevention & control*
  • Humans
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / drug therapy*
  • Male
  • Middle Aged
  • Patient Selection


  • Adrenergic beta-Antagonists