Aim To analyze the risk factors of hypertension with coronary heart disease after percutaneous coronary intervention (PCI) and construct a nomogram warning model for in-stent restenosis (ISR). Methods A total of 182 patients with hypertension and coronary heart disease after PCI in the Second People's Hospital of Fuyang City from June 2020 to March 2022 were selected as the research subjects, and they were divided into ISR group (n＝42) and non-ISR group(n＝140) according to whether ISR occurred after operation or not. The clinical data of the selected patients were analyzed. Univariate, LASSO and Logistic regression analysis were used to screen the risk factors for ISR after PCI with breast hypertension and coronary heart disease. According to the risk factors, a nomogram early warning model was constructed and a goodness-of-fit test was performed. Results A total of 182 patients with hypertension and coronary heart disease after PCI were included in this study, and 42 cases of ISR were confirmed by relevant tests, and the incidence rate was 23.08%. There were differences in smoking, stent diameter, stent length, high uric acid, high sensitivity C-reactive proein (hs-CRP) level, serum amyloid A (SAA) level, and lipoprotein(a) level in the two groups (P＜0.05). Logistic regression analysis showed that diabetes (OR＝4.4,5%CI:1.733～11.498, P＝0.002), long-term smoking (OR＝4.8,5%CI:1.812～11.921, P＝0.001), stent diameter ≤ 3 mm (OR＝4.4,5%CI:1.692～10.947, P＝0.002), high uric acid (OR＝2.0,5%CI:1.092～6.826, P＝0.032), hs-CRP＞10 g/L (OR＝3.3,5%CI:1.493～10.574, P＝0.006), SAA≥10 mg/L (OR＝6.8,5%CI:2.394～17.640, P＝0.000) and lipoprotein(a)≥300 mg/L (OR＝2.5,5%CI:1.209～7.319, P＝0.018) were the incidences of hypertension complicated with coronary heart disease after PCI independent risk factors for ISR. The nomogram early warning model for ISR after PCI for hypertension and coronary heart disease was established based on 7 independent risk factors. The validation results showed that the C-index was 0.864 (95%CI:0.831～0.897), the predictive value of the calibration curve was basically consistent with the measured value, the area under curve (AUC) was 0.834 (95%CI:0.806～0.862), and the decision curve showed that when the threshold probability was in the range of 3% to 100%, there was a higher net benefit value. Conclusions Diabetes mellitus, long-term smoking, stent diameter ≤ 3 mm, high uric acid, hs-CRP＞10 g/L, SAA≥10 mg/L, lipoprotein(a)＞300 mg/L are independent risks of ISR after PCI with hypertension and coronary heart disease. The nomogram model established based on the above risk factors can accurately assess and quantify the risk of ISR after PCI with hypertension and coronary heart disease.