The use of non-selective beta-blockers in patients with cirrhosis: more doubts than certainties

Since 1980s non-selective beta-blockers (NSBBs) have become the cornerstone of medical treatment for portal hypertension in cirrhotic patients (1). Yet, the evidence for their efficacy to prevent variceal bleeding is derived from prospective trials which largely excluded patients with refractory ascites and renal failure that are patients in which the use of beta-blockers is nowadays under debate (2).