Enrasentan associated with compression of portal and central venules is the likely initial event leading to portal hypertension. A serious consequence of portal hypertension is development of bleeding gastroesophageal varices. Nonselective b-adrenoceptor antagonists propranolol and carvedilol have successfully been used to prevent or reduce bleeding episodes.48 They reduce portal venous pressure. Nitrates and more recently other NO donors are also effective. It has been proposed that in liver cirrhosis intrahepatic vascular tone increases due to an imbalance between increased sensitivity of hepatic blood vessels to endogenous vasoconstrictors and the reduced availability of NO. Pharmacotherapy of portal hypertension is in its infancy; it offers an opportunity for the development of new and more selective drugs.

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