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Why carvedilol is preferred in portal hypertension for primary prophylaxis of esophageal variceal bleeding Carvedilol is preferred because it provides a greater and more consistent reduction in portal pressure than traditional non-selective beta-blockers. Dual action of Carvedilol leads to a more effective drop in the hepatic venous pressure gradient (HVPG). Carvedilol acts through two key mechanisms: 1. Non-selective β-blockade (β1 and β2) This action lowers portal pressure by reducing cardiac
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