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All India Institute of Medical Sciences, New Delhi, India.
Am Heart J 2011;161:938–43.
Editor’s note: β-blockade in pulmonary hypertension remains an area of controversy. As acknowledged in this article, previous studies in pulmonary arterial hypertension (PAH) have been disappointing and patients with portopulmonary hypertension improve symptomatically upon withdrawal of β-blockers. Nevertheless, β-blockade seems beneficial in experimental models and sympathetic overload has been documented in PAH, providing the same logical basis for β-blocker treatment that led to studies in left heart failure. The time is ripe to consider such therapy as we move toward increased interest in the right ventricle and its role in prognosis.