{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T21:44:12Z","timestamp":1757454252509},"reference-count":17,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2010,11,9]],"date-time":"2010-11-09T00:00:00Z","timestamp":1289260800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of the American Academy of Nurse Practitioners"],"published-print":{"date-parts":[[2010,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p> <jats:bold>Purpose:<\/jats:bold> The purpose of this article is to educate nurse practitioners about the pathophysiology surrounding the development of portal hypertension and the effective use of nonselective \u00df\u2010blockers to prevent primary bleeding and decrease the mortality risk.<\/jats:p><jats:p> <jats:bold>Data sources:<\/jats:bold> The articles included were retrieved via ISI Web of Science using the years 2004\u20132009 and key words cirrhosis, portal hypertension, esophageal varices, and beta\u2010blockers. This information included scholarly books, journal reviews, retrospective chart reviews, and prospective randomized studies.<\/jats:p><jats:p> <jats:bold>Conclusions:<\/jats:bold> Cirrhosis is the leading cause of portal hypertension in Europe and North America. Esophageal varices are a result of the portosystemic collaterals the body develops to decompress the portal system. Hemorrhage from esophageal varices is a major cause of morbidity and mortality. Prevention of a primary bleed is the goal of therapy and is accomplished with nonselective \u00df\u2010blockers.<\/jats:p><jats:p> <jats:bold>Implications for practice:<\/jats:bold> Very few patients with portal hypertension and esophageal varices are on \u00df\u2010blockers. Use of nonselective \u00df\u2010blockers has been found to lower portal pressure and decreases the risk of bleeding from esophageal varices and therefore decreases mortality. Patients unable to use \u00df\u2010blockers can undergo endoscopic variceal ligation as an alternate method to reduce risk of bleeding.<\/jats:p>","DOI":"10.1111\/j.1745-7599.2010.00567.x","type":"journal-article","created":{"date-parts":[[2010,11,9]],"date-time":"2010-11-09T10:27:26Z","timestamp":1289298446000},"page":"640-647","source":"Crossref","is-referenced-by-count":7,"title":["Use of \u00df\u2010blocker therapy to prevent primary bleeding of esophageal varices"],"prefix":"10.1111","volume":"22","author":[{"given":"Tammy","family":"Tursi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2010,11,9]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"231","article-title":"Pathophysiology of portal hypertension","volume":"59","author":"Cichoz\u2010Lach H.","year":"2008","journal-title":"Journal of Physiology and Pharmacology"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.051700"},{"key":"e_1_2_7_4_1","volume-title":"Harrison's principles of internal medicine","author":"Kasper D.","year":"2005"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2423050784"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-005-0138-2"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2005.04071.x"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(03)02819-0"},{"key":"e_1_2_7_9_1","unstructured":"Murra\u2010Saca J.(2009).El Salvador atlas of gastrointestinal video endoscopy. 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