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Blood-Pressure Medicines That Are Good for Liver Disease

Recent studies have determined that blood pressure medicine has beneficial effects on liver fibrosis, cirrhosis and liver failure. Beta-blockers can lower pressure in veins to reduce the risk of gastrointestinal bleeding (failure). Angiotension II antagonist, losartan, blocks formation of scar tissue, preventing liver failure, allowing the liver to regenerate new tissue.

  1. Fibrosis

    • Fibrosis is accumulation of excess fibrous connective tissue produced by specialized myofibroblasts in the liver. The myofibroblasts proliferate and build scar tissue, which accumulates as liver damage.

    Cirrhosis

    • When the liver is injured repeatedly, cirrhosis of the liver occurs. Scar tissue replaces liver tissue, restricting the flow of blood through the liver. Scarring impairs the liver's ability to control infections, to remove bacteria from the blood, to process food, hormones and drugs and to make proteins for blood clotting. A healthy liver produces bile to help metabolize fats, cholesterol and vitamins.

    Advanced Cirrhosis

    • In the end of cirrhosis, the liver can no longer filter medication in the blood. The cirrhotic liver cannot remove toxins from the blood. The toxins build up in the brain decreasing mental function, increasing confusion, personality changes, memory loss, trouble concentrating, and a change in sleep habits, a condition known as hepatic encephalopathy.

    Beta Blocker Blood Pressure Drug

    • The doctor may prescribe a beta-blocker or nitrate for portal hypertension. Beta-blockers can lower pressure in veins to reduce the risk of bleeding. Gastrointestinal bleeding requires upper endoscopy to look for damaged esophageal veins. A band-ligation can compress veins to stop bleeding. Medicine might be necessary to prevent future episodes.

    Angiotension II Antagonist, Losartan

    • Blood pressure medicine reversed early-stage liver failure in a few patients. Researchers at Newcastle University in England prescribed hypertension drug, losartan, for 14 hepatitis C patients in Spain. The hepatitis caused fibrosis (scarring) of the liver and was progressing to liver failure. In seven out of the fourteen patients, losartan decreased the liver enough to allow the liver to regenerate, giving hope of saving thousands of lives through an alternative other than liver transplant.

    Transcription Factor

    • The researchers discovered a transcription factor, nuclear factor kappa-B (NFkB), which promotes myofibroblasts (cells that produce collagen in the liver) and promotes scar tissue formation. Losartan decreases NF-kB in some patients. Measuring NF-kB in a biopsy tells the researcher which patients will benefit from continued treatment with the blood pressure drug. Researchers think the blood pressure drug losartan blocks the signal pathway, which causes myofibroblasts to die. The scar tissue breaks up, and the liver can repair the damage.

    Expert Insight

    • Angiotensin II and IkB kinase are two natural cytokines. Researchers conducted a pilot study to see if losartan (Cozaar), an angiotensin-converting enzyme (ACE) inhibitor that interferes with the activity of angiotensin II would interfere with IkB kinase which regulates NFkB activity and found out that it would.

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