From January 2014 to June 2015, 1450 patients underwent coronary artery bypass surgery in our ward, of which 335 patients (23% of the total) had combined unilateral and bilateral carotid stenosis of moderate or greater, with a 1% perioperative stroke incidence. On the one hand, the incidence of cerebrovascular events during the perioperative period of coronary artery bypass grafting was significantly higher in patients with moderate or higher carotid stenosis than in those without or with mild carotid stenosis, increasing the risk of disability or death. On the other hand, the dual risk of cardiac and cerebrovascular events in these patients in the postoperative period deserves the attention of our clinicians. After a lot of clinical work, I would like to list some of my experiences in the hope of reducing the risk of cardiovascular and cerebrovascular events in these patients in the long term. From a cardiac perspective, we want to maintain blood pressure between 120/80mmHg-140/90mmHg in heart patients. A blood pressure that is too low will lead to insufficient coronary blood supply and increase the incidence of cardiac events; a blood pressure that is too high will increase the afterload on the heart and may even lead to hypertensive heart failure. Considering the maintenance of the patient’s blood pressure in terms of carotid stenosis, we hope that higher blood pressure maintains cerebral perfusion and reduces the risk of stroke. Then how to maintain the heart-brain balance, both to protect the heart and brain? 1, for coronary patients with combined carotid stenosis of moderate degree or more, systolic blood pressure (high pressure) control can be maintained at 140-160 mmHg, or 20-30 mmHg below the usual systolic pressure without patient discomfort such as dizziness. 2, the patient’s vascular volume load can not space, the intake is not enough, perfusion pressure alone still can not effectively reduce the 3, pay attention to the changes of carotid artery stenosis, regular review of carotid artery must ultrasound, experienced ultrasound experts can distinguish the progress of stenosis, determine whether the plaque is soft or hard plaque, for patients with dizziness, headache can be performed carotid artery and intracranial angiography, in order to more actively and effectively take treatment.