Copyright
©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. May 16, 2015; 7(5): 532-539
Published online May 16, 2015. doi: 10.4253/wjge.v7.i5.532
Published online May 16, 2015. doi: 10.4253/wjge.v7.i5.532
Is it time to replace propranolol with carvedilol for portal hypertension?
Shahab Abid, Saadat Ali, Muhammad Asif Baig, Anam Akbar Waheed, Section of Gastroenterology, Department of Medicine, Aga Khan University, Karachi 74800, Pakistan
Author contributions: Abid S designed the framework of review and critical review of manuscript; Ali S and Baig MA did the literature search, writing and critical review of manuscript; Waheed AA designed the tables and evaluated the language of the manuscript.
Conflict-of-interest: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Shahab Abid, Professor and Head, Section of Gastroenterology, Department of Medicine, Aga Khan University, Stadium Road, PO Box 3500, Karachi 74800, Pakistan. shahab.abid@aku.edu
Telephone: +92-21-34864656 Fax: +92-21-34934294
Received: October 30, 2014
Peer-review started: November 2, 2014
First decision: December 12, 2014
Revised: January 1, 2015
Accepted: January 18, 2015
Article in press: January 20, 2015
Published online: May 16, 2015
Peer-review started: November 2, 2014
First decision: December 12, 2014
Revised: January 1, 2015
Accepted: January 18, 2015
Article in press: January 20, 2015
Published online: May 16, 2015
Core Tip
Core tip: Carvedilol is a promising agent among the beta blockers of recent time that has shown significant effects in portal hypertension hemodynamics. For primary prophylaxis of variceal bleeding, the effects of carvedilol were compared to band ligation in a few trials and showed some promise, but there has been no comparison with propranolol. Patients not responding to propranolol have shown clinical response to carvedilol, opening a new window of clinical application. For secondary prophylaxis of variceal bleeding, carvedilol has been shown to be effective. However no head-to-head trials comparing propranolol and carvedilol for variceal re-bleeding were found in literature.