Thalheimer, UlrichMerli, ManuelaLattanzi, BarbaraGiannelli, ValerioSince the original description of the effectiveness of β-blockers in lowering the portal pressure and therefore the risk of variceal bleeding, more than 500 articles in the English literature on the use of non selective β-blockers (NSBB) in cirrhosis have been published. The use of NSBB in pre-primary prophylaxis of variceal bleeding is currently not indicated. In primary prophylaxis, patients with high risk small varices or large/medium varices should receive primary prophylaxis either with NSBB or with endoscopic band ligation if there are contraindications to NSBB. For secondary prophylaxis the current recommendation is to receive a combination of NSBB and endoscopic variceal ligation. In addition to lowering portal pressure, NSBB can also reduce bacterial translocation, potentially exerting multiple beneficial effects which go beyond the reduction of bleeding risk. Carvedilol is a NSBB with intrinsic anti-α(1)-adrenergic activity, possibly more effective than propranolol in lowering portal hypertension. A potential harmful effect of propranolol in patients with cirrhosis with refractory ascites deserves further confirmation. NSBB remain the cornerstone of therapy in cirrhotic patients with portal hypertension.Keywords β-Blockers, portal hypertension, propranolol, nadolol, carvedilol, cirrhosis, HVPG, variceal bleedingAnn Gastroenterol 2014; 27 (1): 20-26text/htmlapplication/pdfapplication/vnd.openxmlformats-officedocument.wordprocessingml.documenthttp://www.annalsgastro.gr/index.php/annalsgastro/article/view/1473engHellenic Society of Gastroenterology1792-74631108-7471Annals of Gastroenterology; Volume 27, No 1 (2014); 20Beta-blockers in liver cirrhosisinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion2013-12-04Δημοσίευση σε περιοδικόPublication in journalΓαστροεντερολογίαGastroenterologyisi -Gastroenterology & Hepatology covers resources on the anatomy, physiology, biochemistry, and pathology of the digestive system. This category includes specific resources on the prognosis and treatment of digestive diseases; stomach ulcers; metabolic, genetic, infectious and chemically induced diseases of the liver; colitis; diseases of the pancreas and diseases of the rectum.Επιστημονικό άρθροScientific articleΕλληνική Γαστροεντερολογική ΕταιρίαGreek Aggregator OpenArchives.gr | National Documentation Centre (EKT)other