title: Antihypertensive treatment, myocardial infarction, and nocturnal myocardial ischaemia.
abstract: Patients with critical coronary stenoses or hypertrophied ventricles have impaired coronary vasodilator reserve and are at greatest risk of myocardial ischaemia or infarction if subendocardial perfusion pressure falls below the lower threshold of bloodflow autoregulation. During sleep, antihypertensive treatment may cause coronary artery perfusion pressure to fall below these limits in such patients. Unrecognised nocturnal hypotension may be one reason why treatment has not diminished the risk of myocardial infarction in patients with hypertension.
mesh_terms: D000959:Antihypertensive Agents / Q000009:adverse effects*; D002940:Circadian Rhythm; D003326:Coronary Circulation / Q000187:drug effects; D006706:Homeostasis / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D007022:Hypotension / Q000139:chemically induced* / Q000503:physiopathology; D009203:Myocardial Infarction / Q000150:complications* / Q000503:physiopathology; D012307:Risk Factors; D012890:Sleep / Q000502:physiology*
chemical_list: D000959:Antihypertensive Agents