The article explores the relationship between depression and coronary heart disease (CHD), highlighting its role as an independent risk factor for CHD. Depression significantly impacts the onset, progression, and prognosis of CHD, increasing the risk of adverse cardiovascular events. The mechanisms through which depression contributes to CHD include over-activation of the inflammatory response, dysfunction of the hypothalamic-pituitary-adrenocortical (HPA) axis, autonomic nervous system (ANS) dysfunction, endothelial dysfunction, lipid metabolism disorders, and genetic factors. Antidepressant treatment has shown promise in improving psychological status and symptoms in CHD patients with comorbid depression, but its impact on long-term prognosis remains controversial. Traditional Chinese medicine (TCM) and psychological interventions, such as cognitive-behavioral therapy, also offer potential benefits. The article emphasizes the need for further research to clarify the mechanisms and develop effective interventions to improve patient outcomes.The article explores the relationship between depression and coronary heart disease (CHD), highlighting its role as an independent risk factor for CHD. Depression significantly impacts the onset, progression, and prognosis of CHD, increasing the risk of adverse cardiovascular events. The mechanisms through which depression contributes to CHD include over-activation of the inflammatory response, dysfunction of the hypothalamic-pituitary-adrenocortical (HPA) axis, autonomic nervous system (ANS) dysfunction, endothelial dysfunction, lipid metabolism disorders, and genetic factors. Antidepressant treatment has shown promise in improving psychological status and symptoms in CHD patients with comorbid depression, but its impact on long-term prognosis remains controversial. Traditional Chinese medicine (TCM) and psychological interventions, such as cognitive-behavioral therapy, also offer potential benefits. The article emphasizes the need for further research to clarify the mechanisms and develop effective interventions to improve patient outcomes.