Response to β-Blocker Therapy and Risk for Variceal Bleeding

Previous studies in prevention of variceal rebleeding have demonstrated that a drop in hepatic venous pressure gradient (HVPG) below 12 mm Hg or a reduction of ≥20% from baseline in response to β-blocker therapy significantly reduces the risk of bleeding. However, this target is less useful for primary prevention of variceal bleeding because the risk for bleeding is lower and many hemodynamic nonresponders ultimately do not bleed. Investigators sought to identify a better hemodynamic target to define response to β-blocker therapy in primary prophylaxis, and to determine whether an acute response is associated with long-term outcome.

Researchers enrolled 105 patients with large esophageal varices, Child-Pugh score ≤12, and no previous bleedin…