Hepatic venous pressure gradient measurement in pre-primary and primary prophylaxis of variceal hemorrhage.

Pharmacological therapy of portal hypertension can be accomplished according to different objectives. Among them, pre-primary prophylaxis aims to avoid / delay esophageal varices development while the target of primary prophylaxis is protection against first variceal bleeding. Hepatic venous pressure gradient (HVPG) measurement closely reflects portal pressure in most liver diseases whith predominant sinusoidal network involvement. Clinical-hemodynamic correlations have been demonstrated in both pre-primary and primary prophylatic therapy, allowing to establish HVPG measurement as a predictive parameter, not only regarding variceal growth and bled but also of liver disease evolution and other portal hypertensive related complications.