Pathophysiology of portal hypertension

Clin Liver Dis. 2014 May;18(2):281-91. doi: 10.1016/j.cld.2013.12.001. Epub 2014 Feb 25.


Portal hypertension is a major complication of liver disease that results from a variety of pathologic conditions that increase the resistance to the portal blood flow into the liver. As portal hypertension develops, the formation of collateral vessels and arterial vasodilation progresses, which results in increased blood flow to the portal circulation. Hyperdynamic circulatory syndrome develops, leading to esophageal varices or ascites. This article summarizes the factors that increase (1) intrahepatic vascular resistance and (2) the blood flow in the splanchnic and systemic circulations in liver cirrhosis. In addition, the future directions of basic/clinical research in portal hypertension are discussed.

Keywords: Cirrhosis; Fibrosis; Hyperdynamic circulation; Lymphatic system; Nitric oxide; Splenomegaly.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Collateral Circulation
  • Endothelial Cells / physiology
  • Hepatic Stellate Cells / physiology
  • Humans
  • Hypertension, Portal / etiology
  • Hypertension, Portal / physiopathology*
  • Hypertension, Portal / therapy
  • Liver Circulation
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / physiopathology
  • Neovascularization, Pathologic
  • Splanchnic Circulation
  • Vascular Resistance
  • Vasoconstriction
  • Vasodilation