Objective To investigate the effect of tele-monitored home-based cardiac rehabilitation on blood pressure and lipid in patients with coronary heart disease undergoing percutaneous coronary intervention (PCI). Methods A total of 266 patients from January 2016 to March 2018 in our department with coronary heart disease after PCI were enrolled. They were randomly divided into study group (tele-monitored home-based cardiac rehabilitation group) and control group, with 133 cases in each group. The control group received the basic 2-level prevention health education and drug therapy. On the basis of these treatments, the study group received exercise prescription and remote heart rate supervision and rehabilitation guidance from rehabilitation physicians, technicians and nurses with aid of smart phones. The patients were followed up for 12 months, and the blood pressure and lipid levels before and after rehabilitation were compared between the 2 groups. SPSS statistics 17.0 was used to analyze the data. Student′s t test orChi-square test was employed to compare the data between groups. Multiple linear regression analysis was applied to analyze the independent influencing factors of blood pressure and lipid changes. Results In the study group, rehabilitation resulted in significant declines in systolic blood pressure [SBP, (123.7±13.7) vs (128.2±14.5) mmHg] and diastolic blood pressure [DBP, (77.6±11.1) vs (80.7±10.3)mmHg], with increased proportion of those meeting SBP standard [72.9%(97/133) vs 58.6%(78/133)], and in low-density lipoprotein cholesterol (LDL-C) level [(1.64±0.42) vs (1.90±0.59)mmol/L], with larger proportion of normal level [42.1%(56/133) vs 26.3%(35/133)]. While, in the control group, the proportion of the patients meeting the SBP standard was decreased [48.1%(64/133) vs 59.4%(79/133)], and the LDL-C level [(2.23±0.84) vs (2.03±0.80)mmol/L] was increased, with less patients meeting the standard [17.3%(23/133) vs 22.6%(30/133)]. The proportions of the patients meeting DBP standard were increased in both groups [63.2%(84/133) vs 50.4%(67/133), 51.9%(69/133) vs 45.1%(60/133)]. More significant changes were seen in the declines of SBP [(-4.6±14.5) vs (0.2±15.0)mmHg] and LDL-C level [(-0.26±0.54) vs (0.20±0.63)mmol/L] in the study group than the control group. Multiple linear regression analysis showed that tele-monitored home-based cardiac rehabilitation (P=0.006) and age (P=0.010) were independent influencing factors of SBP changes, and tele-monitored home-based cardiac rehabilitation (P<0.001) and carbon dioxide ventilation equivalent (P=0.007) were independent influencing factors for LDL-C changes. Conclusion Tele-monitored home-based cardiac rehabilitation significantly reduces SBP and LDL-C in patients with coronary heart disease after PCI, improves the proportions of those meeting the standards, and helps the control of blood pressure and blood lipid.