Does PMR also inflame the heart muscle? Why more pain at night?

Two great questions to ask your rheumatologist. That said, hopefully some members may have experience. The only thing I could find was the following article that mentions heart related inflammation.

-- Myocardial inflammation in polymyalgia rheumatica assessed using cardiac magnetic resonance imaging:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3718596/
From my experience with two occurrences of PMR and I also have hypotension and take blood pressure medications, I never had any pain at night if my prednisone dosage was doing it's job. I took my morning dose regularly around 6 am daily. I've been in remission since 2018 so hopefully others with experience can share their thoughts.

Another tidbit of information is that their are multiple conditions that mimic PMR which may have similar symptoms that you describe which is another reason for discussing it with your rheumatologist.
-- Diseases that mimic polymyalgia rheumatica (PMR): https://www.medicalnewstoday.com/articles/diseases-that-mimic-polymyalgia-rheumatica

Hello, John. Thank you for taking the time to address my questions. We don't have any competent rheumatologists here in Bellingham so I am working with my GP and gleaning the most valuable information from this site from people who actually have knowledge and experience with PMR. I will continue to do my research.

Hi Christi, I too live in an area with a dire shortage of good specialists. My GP is good, but not well versed in PMR--few GPs are--and uncomfortable being the front line provider for it. I ended up finding a good neurologist about an hour away, and it made all the difference. (I had no luck finding a rheumatologist within a 3 hour distance.) My neurologist has a lot of experience with PMR because of its connection to GCA and has gotten the inflammation under control. If at all possible, I'd encourage you to try to find a specialist for PMR, even if you have to travel a bit. I realize that can be difficult in terms of work schedules, travel, costs, etc., but if you can manage it, I think you'll find it's worth it. I hope you get some relief soon.

Thanks John,
Concise descriptions in this article of conditions mimicking PMR was useful.

Thanks so much for all this information. Diseases that mimic PMR is particularly helpful. I have an elevated calcium level in my blood. This can bring parathyroid issues into the discussion as well. Anyone else had this come up?