Liver, Pancreas, and Biliary TractRandomized comparison of long-term losartan versus propranolol in lowering portal pressure in cirrhosis☆,☆☆
Section snippets
Patients and methods
The study was conducted in patients with cirrhosis who had bled from esophageal varices, recruited from 4 university hospitals in Spain.The final protocol was approved by the Ethical Committee of each participating hospital and the Spanish Ministry of Health and Consumer Affairs.The study was conducted following the principles of the Declaration of Helsinki.Each patient gave written informed consent to participate in the study.
Inclusion criteria were: (1) age between 18 and 75 years, (2)
Results
A total of 25 patients were randomized to receive losartan and 15 propranolol.Three patients did not complete the study because of side effects in 1 patient receiving losartan and after withdrawal of consent in 2 patients (1 propranolol, 1 losartan).Thus, the final analysis includes 23 patients receiving losartan and 14 propranolol.The main characteristics of these patients are summarized in Table 1.There were no differences between patients randomized to losartan or propranolol in any
Discussion
Portal hypertension is the result of increased hepatic resistance and portal inflow.15 Splanchnic vasoconstrictors reduce portal pressure by decreasing portal inflow and have been the mainstay of pharmacologic therapy.1 Recently, the recognition of a dynamic component in the increased hepatic resistance of cirrhosis16 has led to the introduction of vasodilators in the treatment of portal hypertension.17 Endogenous factors, such as endothelin, A-II, and alpha-adrenergic stimulus increase hepatic
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Oral vitamin-A-coupled valsartan nanomedicine: High hepatic stellate cell receptors accessibility and prolonged enterohepatic residence
2018, Journal of Controlled ReleaseCitation Excerpt :Administration of valsartan at its antihypertensive-dose failed to produce antifibrotic effect [24]. Moreover, long-term treatment with ARBs caused adverse effects including; hypotension and reduced glomerular filtration rate [25]. For those reasons, the current study aimed at increasing valsartan delivery to HSCs and accessibility to AT1R and PPAR-γ in high molecular target concentration as a possible cure for liver fibrosis via preparing VA-coupled valsartan-loaded liposomes (VLC).
A New Treatment for Portal Hypertension?
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2023, Journal of the Chinese Medical Association
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Address requests for reprints to: Jaume Bosch, M.D., Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, Villarroel 170, 08036 Barcelona, Spain.[email protected]; fax: (34) 93-451-52-72.
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Supported in part by grants from Plan Nacional de Investigación y Desarrollo (SAF 99-0007 and SAF 2000-0219) and Fondo de Investigaciones Sanitarias (FIS 00/0444); and an award from the Hospital Clinic, Barcelona (to J.G.-A.).