Gastroenterology

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Angiotensin II Receptor Blockers: No Role in Portal Hypertension of Cirrhosis

KEY POINT

Despite the role angiotensin II plays in the pathogenesis of portal hypertension in patients with cirrhosis, antagonists of this enzyme are apparently of little use in prevention of the variceal bleeding it can cause. In fact, controlled studies indicate that angiotensin II receptor blockers (ARBs) produce arterial hypotension in some patients without adequately reducing portal pressure.

SOURCES

González J et al. Randomized comparison of long-term losartan versus propranolol in lowering portal pressure in cirrhosis. Gastroenterology. 2001;121:382–8.

Schepke M et al. Hemodynamic effects of the angiotensin II receptor antagonist irbesartan in patients with cirrhosis and portal hypertension. Gastroenterology. 2001;121:389–95.

Sanyal AJ. Angiotensin receptor blockade and portal hypertension: paradise gained and paradise lost [editorial]. Gastroenterology. 2001;121:487–90.