Prevention of Esophageal Varices by Beta-Adrenergic Blockers

Inclusion Criteria: * Liver biopsy compatible with cirrhosis. * Absence of gastroesophageal varices. * An increased hepatic venous pressure gradient (HVPG) (6mmHg). * Age over 18 and below 76 years. * Informed, written consent. * Absence of exclusion criteria. Exclusion Criteria: * Presence of ascites that requires specific treatment (diuretics, paracentesis, peritoneo-venous shunt, etc). * Proven hepatocellular carcinoma by radiological or histological criteria. * Splenic or portal vein thrombosis by Doppler-ultrasound. * Presence of any concurrent disease that is expected to decrease life expectancy to less than one year. * Patients taking diuretics, beta-blockers, clonidine, prazosin, nitrates, molsidomine and any drug which may have an effect on splanchnic hemodynamics/portal pressure. * Patients participating in other pharmacological randomized clinical trials. * Patients with primary biliary cirrhosis and primary sclerosing cholangitis will also be excluded since these entities have a slower progression of the disease, are usually enrolled in other clinical trials and are transplanted at an earlier stage. * Contraindications to beta-blockers: asthma, COPD with positive broncoconstrictive test, heart failure, A-V block, aortic valve stenosis, organic psychosis, insulin-dependent diabetes, hypersensitivity to beta-blockers. * Women who are pregnant, nursing or of childbearing potential and who are not using oral or mechanical contraception.