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Portal hypertension is responsible for most of the complications associated with liver cirrhosis, including variceal hemorrhage,
ascites, and hepatic encephalopathy. It has become clear that a decrease in portal pressure can prevent or manage these serious
complications. Until now, the pharmacotherapy of portal hypertension has focused on agents that reduce splanchnic blood flow,
such as non-selective beta blockers and splanchnic vasoconstrictors. However, recent advances in the knowledge of the pathophysiology
of portal hypertension have directed future treatment towards modulating the increased intrahepatic vascular resistance, in
addition to managing the splanchnic circulation. Consequently, agents that modulate either the hyperdynamic circulation or angiogenesis
are new therapeutic targets for managing portal hypertension. Several have been developed or are under investigation. To
incorporate these pharmacologic approaches into clinical practice, data on patient-oriented outcomes are needed. (Korean J Med
77:282-289, 2009) |
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