Improving Management of Portal Hypertension: The Potential Benefit of Non-Etiological Therapies in Cirrhosis

Portal hypertension is the consequence of cirrhosis and results from increased sinusoidal vascular resistance and hepatic blood inflow. Etiological therapies represent the first intervention to prevent a significant increase in portal pressure due to chronic liver damage. However, other superimposed...

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Bibliographic Details
Published in:Journal of clinical medicine 2023-01, Vol.12 (3), p.934
Main Authors: Bitto, Niccolò, Ghigliazza, Gabriele, Lavorato, Stanislao, Caputo, Camilla, La Mura, Vincenzo
Format: Article
Language:English
Subjects:
Ascites
Bacterial infections
Blood
Clinical medicine
Drug dosages
Drug withdrawal
Etiology
Hemodynamics
Hepatology
Hypertension
Infections
Inflammation
Kidneys
Liver cirrhosis
Medical prognosis
Mortality
Observational studies
Oxidative stress
Peritonitis
Proteins
Review
Weight control
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Summary:Portal hypertension is the consequence of cirrhosis and results from increased sinusoidal vascular resistance and hepatic blood inflow. Etiological therapies represent the first intervention to prevent a significant increase in portal pressure due to chronic liver damage. However, other superimposed pathophysiological drivers may worsen liver disease, including inflammation, bacterial translocation, endothelial dysfunction, and hyperactivation of hemostasis. These mechanisms can be targeted by a specific class of drugs already used in clinical practice. Albumin, rifaximin, statins, aspirin, and anticoagulants have been tested in cirrhosis and were a topic of discussion in the last Baveno consensus as non-etiological therapies. Based on the pathogenesis of portal hypertension in cirrhosis, our review summarizes the main mechanisms targeted by these drugs as well as the clinical evidence that considers them a valid complementary option to manage patients with cirrhosis and portal hypertension.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm12030934