Abstract: AIM:To investigate the relationship between depression and lipid levels in elderly patients with coronary heart disease (CHD). METHODS: Data were collected for 168 elderly CHD patients and 50 healthy elderly volunteers (control group). According to the results of self-rating depression scale (SDS) and sublist of hospital anxiety and depression scale (HAD), the 168 elderly CHD patients were divided into two groups: CHD with depression group and CHD without depression group. Serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and lipoprotein α ［Lp(α)］ were tested. RESULTS: Significant difference was observed in serum TC, TG and LDL-C between CHD with depression group and CHD without depression group, in serum LDL-C between CHD with depression group and control group and in serum TC, TG and LDL-C between CHD with depression group and control group (all P<0.01). Stepwise multivariate regression analysis demonstrated that TC, TG and LDL-C markedly influenced depression. Multivariate logistic regression analysis showed that TC and LDL-C were independent risk factors for CHD in elderly patients. CONCLUSION: Changes of blood lipids are associated with depression, especially in patients with CHD. Depression and changes of lipid levels both promote the development of CHD.