Clonidine for Portal Hypertension: A Sympathetic Solution?
Authors: Laurence M. Blendis
Journal: Annals of Internal Medicine (1992)

Editorials15 March 1992Clonidine for Portal Hypertension: A Sympathetic Solution?Laurence M. Blendis, MDLaurence M. Blendis, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-116-6-515 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe major consequences of alcoholic cirrhosis, esophageal varices and ascites, emerge years before hepatic failure occurs and are related to portal hypertension. The pathogenesis of elevated portal pressure involves both increased resistance and increased portal blood flow (1). Early in the course of portal hypertension, regardless of cause, portal blood flow increases (2), possibly because of the opening of portosystemic shunts; this increase is associated with a generalized hyperdynamic circulation and peripheral vasodilation.It has been known for nearly 40 years that patients with cirrhosis have a hyperdynamic circulation associated with increased cardiac output and heart rate, reduced arterial blood...References1. BenoitWomackHernandezGranger JWLD. "Forward and backward" flow mechanisms of portal hypertension. Gastroenterology. 1985;89:1092-6. CrossrefMedlineGoogle Scholar2. VorobioffBredfeltGroszmann JJR. Hyperdynamic circulation in portal hypertensive rat model; a primary factor for the maintenance of chronic portal hypertension. Am J Physiol. 1978;244: G52-7. Google Scholar3. BomzonBlendis AL. Cardiovascular complications of liver disease. Boca Raton, Florida: CRC Press; 1989. Google Scholar4. HenriksenRing-LarsenKanstrupHristensen JHIN. 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