{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T22:12:17Z","timestamp":1790460737477,"version":"4.1.0"},"reference-count":58,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T00:00:00Z","timestamp":1681689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Portal hypertension (PH) is the most common complication ofcirrhosis and represents the main driver of hepatic decompensation. The overarching goal of PH treatments in patients with compensated cirrhosis is to reduce the risk of hepatic decompensation (i.e development of ascites, variceal bleeding and\/or hepatic encephalopathy). In decompensated patients, PH\u2010directed therapies aim at avoiding further decompensation (i.e. recurrent\/refractory ascites, variceal rebleeding, recurrent encephalopathy, spontaneous bacterial peritonitis or hepatorenal syndrome) and at improving survival. Carvedilol is a non\u2010selective beta\u2010blocker (NSBB) acting on hyperdynamic circulation\/splanchnic vasodilation and on intrahepatic resistance. It has shown superior efficacy than traditional NSBBs in lowering PH in patients with cirrhosis and may be, therefore, the NSBB of choice for the treatment of clinically significant portal hypertension. In primary prophylaxis of variceal bleeding, carvedilol has been demonstrated to be more effective than endoscopic variceal ligation (EVL). In patients with compensated cirrhosis carvedilol achieves higher rate of hemodynamic response than propranolol, resulting in a decreased risk of hepatic decompensation. In secondary prophylaxis, the combination of EVL with carvedilol may prevent rebleeding and non\u2010bleeding further decompensation better than that with propranolol. In patients with ascites and gastroesophageal varices, carvedilol is safe and may improve survival, as long as no impairment of the systemic hemodynamic or renal dysfunction occurs, with maintained arterial blood pressure as suitable safety surrogate. The target dose of carvedilol to treat PH should be 12.5\u00a0mg\/day. This review summarizes the evidence behind Baveno\u2010VII recommendations on the use of carvedilol in patients with cirrhosis.<\/jats:p>","DOI":"10.1111\/liv.15559","type":"journal-article","created":{"date-parts":[[2023,3,10]],"date-time":"2023-03-10T16:20:28Z","timestamp":1678465228000},"page":"1183-1194","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":99,"title":["Carvedilol as the new non\u2010selective beta\u2010blocker of choice in patients with cirrhosis and portal hypertension"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8148-3769","authenticated-orcid":false,"given":"Laura","family":"Turco","sequence":"first","affiliation":[{"name":"Internal Medicine Unit for the Treatment of Severe Organ Failure IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4590-3583","authenticated-orcid":false,"given":"Thomas","family":"Reiberger","sequence":"additional","affiliation":[{"name":"Vienna Hepatic Hemodynamic Lab, Division of Gastroenterology and Hepatology, Department of Medicine III Medical University of Vienna  Vienna Austria"},{"name":"Christian Doppler Laboratory for Portal Hypertension and Liver Fibrosis Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Vitale","sequence":"additional","affiliation":[{"name":"Internal Medicine Unit for the Treatment of Severe Organ Failure IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4685-7184","authenticated-orcid":false,"given":"Vincenzo","family":"La\u00a0Mura","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Angelo Bianchi Bonomi Hemophilia and Thrombosis Center  Milan Italy"},{"name":"Department of Pathophysiology and Transplantation Universit\u00e0 degli Studi di Milano  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,4,17]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23478"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.12.022"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2017.10.020"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep4.1855"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2007.05.024"},{"key":"e_1_2_12_7_1","article-title":"Measurement of the hepatic venous pressure gradient and transjugular liver biopsy","volume":"160","author":"Reiberger T","year":"2020","journal-title":"J Vis Exp"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510300628"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2021.10.023"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2021.09.009"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.05.022"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa044456"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28264"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31875-0"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cld.2019.07.007"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2014.05.047"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27376"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510280405"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2021203051"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840080532"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2008.12.011"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2017.12.027"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198112033052302"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28906"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2019.05.050"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/cld.1210"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2021.04.077"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2012-304038"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2004.01.003"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840200310"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2003.50211"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.50.4.571"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2018.10.005"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0148868"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i32.9566"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/17.suppl_B.24"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.292.18.2227"},{"issue":"10","key":"e_1_2_12_38_1","article-title":"Carvedilol versus traditional, non\u2010selective beta\u2010blockers for adults with cirrhosis and gastroesophageal varices","volume":"10","author":"Zacharias AP","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510300124"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840360612"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2002.01190.x"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.14576"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-012-9353-8"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2004.05.004"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2016-311735"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2016-312814"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2022.05.021"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.30220"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23045"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.16189"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12634"},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.05.011"},{"key":"e_1_2_12_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.03.048"},{"issue":"4","key":"e_1_2_12_54_1","article-title":"Primary prevention of variceal bleeding in people with oesophageal varices due to liver cirrhosis: a network meta\u2010analysis","volume":"4","author":"Roccarina D","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_12_55_1","first-page":"287","article-title":"Carvedilol for prevention of variceal bleeding: a systematic review and meta\u2010analysis","volume":"32","author":"Malandris K","year":"2019","journal-title":"Ann Gastroenterol"},{"key":"e_1_2_12_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2017.02.005"},{"key":"e_1_2_12_57_1","article-title":"Carvedilol achieves higher hemodynamic response and lower rebleeding rates than propranolol in secondary prophylaxis","author":"Jachs M","year":"2022","journal-title":"Clin Gastroenterol Hepatol"},{"key":"e_1_2_12_58_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28352"},{"key":"e_1_2_12_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.10.003"}],"container-title":["Liver International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/liv.15559","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/liv.15559","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T04:49:27Z","timestamp":1697431767000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/liv.15559"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,17]]},"references-count":58,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1111\/liv.15559"],"URL":"https:\/\/doi.org\/10.1111\/liv.15559","archive":["Portico"],"relation":{},"ISSN":["1478-3223","1478-3231"],"issn-type":[{"value":"1478-3223","type":"print"},{"value":"1478-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,17]]},"assertion":[{"value":"2022-08-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}