Spironolactone may be a good choice for all people, including black people, who have tried other drugs but still have high blood pressure. It is often used for people who have already tried three or more medicines and their blood pressure is still high. Sometimes it is taken along with two or more other medicines when high blood pressure isn’t coming down.

It may not work the same in black people as it does in non-black people, but it is still a good choice. Studies of spironolactone did not include many black people. So, it is unclear if it works the same in black people as it does in white people.

Spironolactone may lower potassium levels. This is especially true for black people. Potassium levels need to be checked often for all people taking spironolactone.