Portal Hypertension and Cirrhosis: From Evolving Concepts to Better Therapies

Portal hypertension, defined as an increase in pressure gradient between the portal venous system and the hepatic veins, is a major consequence of the progression of chronic liver disease, because it gives rise to most of the complications that lead to death or to listing for liver transplantation in patients with cirrhosis. The prognosis of these patients has improved dramatically in the past three decades, as illustrated by the observation that short-term mortality rates after variceal bleeding have declined from 50% in the 1980s to values of ~10% in current series, which leads to the suggestion that a mortality rate greater than 20% should be considered excessive nowadays.