Will Liver Problems Cause High Blood Pressure?

The relationship between high blood pressure and the liver is more connected than many realize. When the liver becomes damaged, particularly in cases of cirrhosis, it can lead to a specific type of high blood pressure called portal hypertension, a serious complication of liver disease.

What Is Portal Hypertension?

Portal hypertension is defined as increased blood pressure within the portal venous system, a network of veins that carry blood from the digestive organs to the liver. This system includes the portal vein, which supplies about two-thirds of the liver’s blood flow and normally maintains a slightly higher pressure that allows proper filtration and circulation.

Pressure builds within the system when resistance to this blood flow increases, as it often does in liver disease. The elevated portal blood pressure is known as portal hypertension or portal vein hypertension. The most common cause of portal hypertension is cirrhosis. In cirrhosis, scar tissue replaces healthy liver cells and disrupts normal circulation, making it difficult for blood to pass through the liver. As a result, pressure rises in the portal vein, leading to the development of portal hypertension. There are usually no symptoms of portal hypertension in its early stages.

What Stage of Liver Disease Do You Get Portal Hypertension?

Portal hypertension usually develops in the advanced stages of chronic liver disease, particularly when liver damage becomes severe and long-lasting. As liver disease progresses, structural changes like fibrosis (scar tissue) and regenerative nodules form in the liver. These changes not only block normal blood flow and raise pressure in the portal venous system but also lead to serious complications such as bleeding in the intestines, fluid buildup in the abdomen (ascites), brain-related symptoms (encephalopathy) and even problems with the kidneys, lungs and heart.

In the early stages of liver disease, portal hypertension may not be present, and treatment is focused on stopping the cause of liver damage, such as managing a virus or reducing alcohol use. But in end-stage liver disease, where the damage is mostly fixed and irreversible, portal hypertension becomes more likely and harder to manage. Treatment is focused on relieving pressure and preventing complications at this point.

Can Portal Hypertension Be Cured?

While portal hypertension itself may not be completely curable, it can often be managed through a combination of medical treatments and procedures aimed at relieving symptoms and preventing complications. Since cirrhosis is the most common cause of portal hypertension, treatment begins with addressing the underlying liver damage.

Doctors may prescribe medications to help lower portal blood pressure and reduce the risk of swollen blood vessels bursting, particularly in the stomach, esophagus or intestines, where blood is rerouted due to blocked flow in the portal vein. These medications are not recommended for everyone, as they may have side effects or interact with other treatments.

If medication is not enough, surgical procedures may be needed. A common approach is to place rubber bands or special chemicals into swollen blood vessels to block them off and prevent life-threatening bleeding. Sometimes, TIPS (transjugular intrahepatic portosystemic shunt) reduces pressure in the portal venous system by creating a new blood flow pathway through the liver.

In more severe cases, such as liver failure or when surgery does not control the pressure, patients may require a liver transplant. While there is no single cure for portal hypertension, timely treatment and ongoing care can significantly improve quality of life and reduce risks.