Beta blocker prophylaxis for patients with variceal hemorrhage

J Clin Gastroenterol. 2005 May-Jun;39(5):435-40. doi: 10.1097/01.mcg.0000159222.16032.98.


Goals: To characterize beta blocker therapy for the primary and secondary prevention of variceal hemorrhage.

Background: Variceal hemorrhage is one of the more frequent and severe complications of portal hypertension due to liver disease. Beta blocker therapy has been demonstrated to decrease risk of first bleed in patients with evidence of varices and recurrent bleeding and mortality in patients with history of prior variceal hemorrhage.

Study: A total of 106 patients with liver disease hospitalized with suspected variceal hemorrhage were retrospectively reviewed.

Results: Half of patients had known varices, 44 (41.5%) of whom had experienced prior variceal hemorrhage. Only 21 (20%) were receiving beta blocker therapy at admission and 41 (48%) at discharge. The majority were not receiving therapy for primary prophylaxis (94%). Specific characteristics associated with beta blocker use could not be identified, although more patients with history of greater than two variceal hemorrhages were receiving beta blocker at admission (73% vs. 41%, P = 0.04)

Conclusions: This study suggests that liver disease patients with varices are often not receiving beta blocker therapy to reduce risk of first or subsequent variceal hemorrhage. Opportunity exists to optimize use of this proven prophylactic treatment and bridge an apparent gap in standard of care.

Publication types

  • Comparative Study

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Endoscopy, Gastrointestinal
  • Esophageal and Gastric Varices / diagnosis
  • Esophageal and Gastric Varices / etiology
  • Esophageal and Gastric Varices / prevention & control*
  • Female
  • Follow-Up Studies
  • Gastrointestinal Hemorrhage / diagnosis
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / prevention & control*
  • Humans
  • Hypertension, Portal / complications
  • Length of Stay
  • Male
  • Middle Aged
  • Propranolol / therapeutic use*
  • Retrospective Studies
  • Treatment Outcome


  • Adrenergic beta-Antagonists
  • Propranolol