What is the most common cause of Portal Hypertension in the United States?

The most common cause of portal hypertension in the United States is cirrhosis. Cirrhosis results from various liver diseases that lead to chronic damage and scarring of the liver tissues, where the normal architecture is disrupted. This scarring increases resistance to blood flow through the liver, thereby raising the pressure in the portal venous system, which leads to portal hypertension.

Cirrhosis can have multiple underlying causes, including viral hepatitis, non-alcoholic fatty liver disease, and alcoholic liver disease, among others. While alcoholic liver disease is indeed a significant contributor to cirrhosis, cirrhosis itself encompasses more than just issues stemming from alcohol use. It serves as a critical endpoint that reflects long-standing liver injury, making it the most frequent cause of portal hypertension overall.

Other options like chronic kidney disease and hepatic vein obstruction are not primary causes of portal hypertension. Chronic kidney disease impacts renal function but does not directly lead to increased portal pressure. Hepatic vein obstruction, while it can cause portal hypertension, is less prevalent compared to cirrhosis, which accounts for a broader range of liver dysfunctions leading to the condition.