Beta-Blockers to Prevent Gastroesophageal Varices in Cirrhosis

To the Editor: The report by Groszmann et al. (Nov. 24 issue) 1 answers a question my colleagues and I first raised several years ago 2 — namely, that of the potential value of nonselective beta-blockade in the treatment of unselected patients with cirrhosis. We hypothesized that the use of nonselective beta-blockers would lead to a lower rate of esophageal variceal hemorrhage, death, or both, if these agents were given to all such patients. With regard to the study by Groszmann et al., the classification of a therapy-induced drop in the heart rate to below 50 beats per minute as a serious . . .