Hypertension and myocardial ischemia are closely related, long-term hypertension can cause coronary atherosclerosis, both systolic and diastolic blood pressure increase will increase the risk of coronary heart disease, myocardial ischemia. A large number of studies have shown that hypertension is the main risk factor for coronary heart disease and myocardial ischemia, and long-term hypertension can cause heart, brain, kidney, and produce damage can also cause myocardial ischemia, so for myocardial ischemia caused by hypertension, comprehensive measures should be taken: 1, the blood pressure to reach the target value, and the current use of long-lasting preparations should be used as much as possible to make the blood pressure can be controlled in 24 hours; 2, effective use of antimyocardial ischemia drugs, such as nitrate Ester preparations, β-blockers; 3, antiplatelet therapy; 4, the use of statins. In conclusion, hypertension can cause coronary atherosclerosis leading to myocardial ischemia, and individualized principles should be adopted for comprehensive prevention and treatment.