{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:24:16Z","timestamp":1792153456033,"version":"4.4.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":5906,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"name":"Fondo de Investigaciones Sanitarias","award":["95\/0418"],"award-info":[{"award-number":["95\/0418"]}]},{"name":"Fondo de Investigaciones Sanitarias","award":["97\/1309"],"award-info":[{"award-number":["97\/1309"]}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[1999,7]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>Only some patients show a substantial hepatic venous pressure gradient (HVPG) reduction after propranolol, which makes it desirable to investigate drugs with greater portal hypotensive effect. The aim of this study was to investigate whether carvedilol, a nonselective beta-blocker with anti-alpha<jats:sub>1<\/jats:sub>-adrenergic activity, may cause a greater HVPG reduction than propranolol. Thirty-five cirrhotic patients had hemodynamic measurements before and after the random administration of carvedilol (n = 14), propranolol (n = 14), or placebo (n = 7). Carvedilol markedly reduced HVPG, from 19.5 \u00b1 1.3 to 15.4 \u00b1 1 mm Hg (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; .0001). This HVPG reduction was greater than after propranolol (\u221220.4 \u00b1 2 vs. \u221212.7 \u00b1 2%, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; .05). Moreover, carvedilol decreased HVPG greater than 20% of baseline values or to \u226412 mm Hg in a greater proportion of patients (64% vs. 14%, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; .05). Both drugs caused similar reductions in hepatic and azygos blood flows, suggesting that the greater HVPG decrease by carvedilol was because of reduced hepatic and portocollateral resistance. Propranolol caused greater reductions in heart rate and cardiac output than carvedilol, whereas carvedilol caused a greater decrease in mean arterial pressure (\u221223.1 vs. \u221211%, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; .05). Thus, carvedilol has a greater portal hypotensive effect than propranolol in patients with cirrhosis, suggesting a greater therapeutic potential. However, it causes arterial hypotension, which calls for careful evaluation before its long-term use<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.510300124","type":"journal-article","created":{"date-parts":[[2004,7,28]],"date-time":"2004-07-28T07:26:03Z","timestamp":1090999563000},"page":"79-83","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":164,"title":["Carvedilol, a new nonselective beta-blocker with intrinsic anti-alpha1-adrenergic activity, has a greater portal hypotensive effect than propranolol in patients with cirrhosis"],"prefix":"10.1097","volume":"30","author":[{"given":"Rafael","family":"Ba\u00f1ares","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Moitinho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bel\u00e9n","family":"Piqueras","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Casado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan-Carlos","family":"Garc\u00eda-Pag\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"de Diego","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaume","family":"Bosch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"10.1002\/hep.510300124-BIB1|cit1","doi-asserted-by":"crossref","first-page":"1532","DOI":"10.1056\/NEJM199105303242202","article-title":"Beta-adrenergic antagonists drugs in the prevention of gastrointestinal bleeding in patients with cirrhosis and esophageal varices","volume":"324","author":"Poynard","year":"1991","journal-title":"N Engl J Med"},{"key":"10.1002\/hep.510300124-BIB2|cit2","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1002\/hep.1840130517","article-title":"Propranolol in the prevention of the first hemorrhage from esophagogastric varices: a multicenter, randomized, clinical 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