Which medication class reduces the risk of recurrent variceal bleeding by about 50%?

Which medication class reduces the risk of recurrent variceal bleeding by about 50%?

• A. Beta-blockers
• B. Proton pump inhibitors
• C. Anticoagulants
• D. Diuretics

Answer: (A)

Reducing portal hypertension lowers the chance that varices will rupture. Nonselective beta-blockers achieve this by blocking both beta-1 and beta-2 receptors. Blocking beta-1 lowers heart rate and cardiac output, while blocking beta-2 causes splanchnic (gut) blood vessels to constrict, cutting down blood flow into the portal venous system. The result is decreased portal pressure, which translates into fewer breaches of the variceal vessels. In patients who have already bled, this approach reduces the risk of recurrent bleeding by about 50%. The other options don’t target portal pressure: proton pump inhibitors protect against ulcers but don’t affect variceal pressure; anticoagulants alter coagulation and can worsen bleeding risk; diuretics help manage ascites but don’t reduce variceal bleed risk.

Reducing portal hypertension lowers the chance that varices will rupture. Nonselective beta-blockers achieve this by blocking both beta-1 and beta-2 receptors. Blocking beta-1 lowers heart rate and cardiac output, while blocking beta-2 causes splanchnic (gut) blood vessels to constrict, cutting down blood flow into the portal venous system. The result is decreased portal pressure, which translates into fewer breaches of the variceal vessels. In patients who have already bled, this approach reduces the risk of recurrent bleeding by about 50%.

The other options don’t target portal pressure: proton pump inhibitors protect against ulcers but don’t affect variceal pressure; anticoagulants alter coagulation and can worsen bleeding risk; diuretics help manage ascites but don’t reduce variceal bleed risk.