Carvedilol Versus Endoscopic Band Ligation for Primary Prophylaxis of Oesophageal Variceal Bleeding

Inclusion Criteria: * • Aged \>18 years * Cirrhotic patients with arterial hypertension * Endoscopic evidence of medium/large-sized esophageal varices Exclusion Criteria: * • History of variceal bleeding or previous primary prevention of varices. * Portal vein thrombosis or previous porto-systemic shunts as TIPS. * Patients on drugs affecting portal pressure (beta blockers, nitrates). * Advanced cardiovascular disease including acute myocardial infarction, atrio-ventricular block, congestive heart failure, chronic peripheral ischemia, severe bradycardia. * Patients with severe respiratory diseases (COPD, bronchial asthma). * Uncontrolled diabetes mellitus * Renal impairment * Hepatocellular carcinoma * Allergy to carvedilol * Pregnancy or lactation