Spironolactone for Regulating Blood Pressure after Intracerebral Hemorrhage

Blood pressure treatment is important for all survivors of intracerebral hemorrhage (ICH). High blood pressure after ICH puts patients at high risk for future strokes and memory problems. Nearly all doctors agree that patients  who have had a brain hemorrhage should be treated with blood pressure medications. But doctors are unsure which type of blood pressure treatment is best for patients with brain hemorrhage.

Most patients with brain hemorrhage are treated with a combination of blood pressure medications that work in different ways. However, blood pressure may be hard to control after brain hemorrhage. Spironolactone is a type of blood pressure medication that works by blocking a specific kidney protein. We think that this kidney protein may be higher than normal in patients with brain hemorrhage. This protein may be a cause of high blood pressure and so blocking this protein may be more effective in controlling blood pressure after brain hemorrhage. The purpose of this research study is to compare the effect of spironolactone to the effect of other blood pressure medications in patients with a recent brain hemorrhage to see which is better at lowering blood pressure after 3 months.

Spironolactone is approved by the U.S. Food and Drug Administration (FDA) for the treatment of high blood pressure. It is possible to receive Spironolactone outside of this clinical trial. Patients who are already on, or planning to be on, Spironolactone are excluded from this study. We will measure levels of kidney proteins in the blood to see if we can predict which patients will respond best to spironolactone.