Do Patients with Varices Need to Remain on Propranolol Forever?

Beta-blockers significantly reduce the likelihood of bleeding in patients with esophageal varices. However, bleeding risk is highest during the first 2 years after diagnosis of varices, and it is unknown whether beta-blockers need be continued beyond this high-risk period. To examine outcomes associated with patients who discontinue beta-blocker therapy, researchers performed a follow-up study of 49 (of 102) patients with cirrhosis and portal hypertension who had participated in a randomized, placebo-controlled trial of propranolol for primary prevention of esophageal variceal hemorrhage (EVH).

Propranolol reduced the likelihood of EVH and death in the primary prevention trial. At the conclusion of the study, patients who remained EVH-free w…