Stroke survivors with high blood pressure could benefit from a common, inexpensive pill

An inexpensive drug could help stroke survivors whose blood pressure remains high despite treatment, a new study suggests.

The research, known as the REDUCE trial, aimed to determine whether adding spironolactone, a medication commonly known as the water pill, could help lower blood pressure after a stroke. The results were presented at the American Heart Association Scientific Sessions, November 6-9, 2026, in Chicago.

The participants were divided into two groups. One added spironolactone to his usual treatment, while the other continued his usual post-stroke care.

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Researchers tracked participants’ blood pressure at home over the next six months to determine if adding the drug made a difference.

After three months, the highest blood pressure index was on average nearly eight points lower in people taking spironolactone than in those receiving usual care — about 126 versus 133, the study found.

Researchers found that adding spironolactone to regular stroke care helped lower blood pressure more than usual treatment alone. (iStock)

More patients taking spironolactone also achieved the recommended blood pressure goal of less than 130/80. This included 52% of those taking the drug, compared to 30% receiving usual care.

“Reducing blood pressure is the most important step in preventing another stroke, but many survivors have difficulty reaching recommended blood pressure goals after a stroke,” study co-senior author Dr. Jordana Cohen, associate professor of medicine and epidemiology at the University of Pennsylvania, said in a press release.

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“When spironolactone was added to post-stroke care, we saw a significant drop in blood pressure, which could reduce the risk of future strokes and heart attacks,” she added.

Dr. Alfred Joshua, a California-based board-certified emergency physician and former chief medical officer who was not involved in the research, said the results are encouraging but do not yet show that the drug prevents a subsequent stroke.

Researchers found that 52% of patients taking spironolactone reached the recommended blood pressure goal, compared to 30% receiving usual care after a stroke. (iStock)

“We already know that controlling blood pressure reduces the risk of another stroke,” Joshua told Fox News Digital. “This study measured blood pressure, so the question of whether adding spironolactone leads to fewer repeat strokes remains open.”

Spironolactone works by helping the body get rid of excess salt and water, which can lower blood pressure, according to the U.S. National Library of Medicine. It also causes the body to retain potassium, so patients taking it should have their levels checked, the drug’s prescribing information states.

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Joshua warned that high potassium is one of the main safety concerns because it can develop without symptoms. The risk may be higher for people with kidney problems and those who take certain medications or potassium supplements.

The drug can also lower blood pressure enough to cause dizziness, he added.

Spironolactone helps the body eliminate excess salt and water, which may lower blood pressure in patients requiring additional treatment. (iStock)

“If your blood pressure is still high after a stroke, take your home readings to your clinician and ask if this medication is right for you,” Joshua advised.

Limitations of the study

The trial ended prematurely with 160 participants instead of the planned 200, and about 15% of them did not have blood pressure measurements after three months, the researchers noted.

People taking spironolactone also took slightly more blood pressure medications than those receiving usual care.

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The study was not designed to determine whether spironolactone actually prevents another stroke or heart attack. Larger and longer studies are needed to answer this question, according to the researchers.

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Fox News Digital has contacted the researchers for comment.