Objective To observe the clinical effect of Shexiang Baoxin pills combined with Nifedipine controlled-release tablets in the treatment of hypertension complicated with coronary heart disease. Methods A total of 122 patients with hypertension and coronary heart disease admitted to our hospital from January to September 2022 were randomly divided into control group and experimental group, with 61 cases in each group. The control group was treated with benazepril tablets combined with nifedipine controlled-release tablets, and the experimental group was treated with Shexiang Baoxin pill on the basis of the control group. The clinical efficacy, cardiac function index, blood pressure control, inflammatory factor level, hospitalization time and coronary heart disease related clinical indicators were compared between the two groups. Results The total effective rate of treatment in the experimental group was higher than that in the control group ( P <0.05). LVEF and 6 MWD in the experimental group were higher than those in the control group, LVDD and LVDS were lower than those in the control group ( P <0.05). The diastolic blood pressure, systolic blood pressure, systolic blood pressure load and diastolic blood pressure load in the experimental group were lower than those in the control group ( P <0.05). The CRP, IL-6, TNF-α and hospitalization time in the experimental group were lower than those in the control group ( P <0.05). The frequency and duration of ischemic attack, the distance of ST segment depression and Hcy in the experimental group were lower than those in the control group ( P <0.05). Conclusion Shexiang Baoxin pills combined with nifedipine controlled-release tablets has a good effect in the treatment of hypertension complicated with coronary heart disease, which can control blood pressure, improve cardiac function under relatively safe conditions, and is worthy of clinical application.