Objective To investigate the interaction between apolipoprotein B gene mutation and attack risk of coronary heart disease and traditional risk factors. Methods Clinical data of 386 cases of coronary heart disease and 386 cases with noncoronary heart disease treated with no lipidlowering therapy were chosen in the period from January 2010 to January 2016. R532W mutation of ApoB coding gene was detected in all patients. The blood lipid level of different kinds of genotype was analyzed. The correlation between R532W mutation and coronary heart disease were analyzed and the interaction between this mutation and risk factors of coronary heart disease were evaluated. Results The proportion of hypertension, diabetes, smoking, TC, LDLC, apo B and FBG of CHD group were significantly higher than that of nonCHD group（P＜0.05）. The levels of SBP, DBP, HDLC, Apo AI and Apo AI/Apo B of CHD group were significantly lower than that of nonCHD group（P＜0.05）. The TC levels of patients with AA type were significantly lower than that of GA type（P＜0.05）. There was no significant difference in serum lipid levels among CHD patients with AA type, GG type and GA type（P＜0.05）. The TC levels of nonCHD patients with AA type were significantly lower than that of GA type（P＜0.05）. There were significant differences in the genotype distribution of R532W in POB coding gene between non CHD group and CHD group （P＜0.05）. The minimum allele A distribution frequency of CHD group were significantly lower than nonCHD group（P＜0.05）. In the dominant genetic model, the risk of coronary heart disease in allele A carriers were decreased for 29% lower than non carriers （P＜0.05）. After adjustment for confounding factors, the risk of coronary heart disease in allele A carriers were decreased for 33% lower than non carriers（P＜0.05）. There was no correlation between R532W mutation and the risk of coronary heart disease in recessive genetic model and additive genetic model（P＞0.05）. The results of interaction evaluation showed that R532W mutation in APOB coding gene and the history of hypertension and smoking possess positive additive interaction effect in the pathogenesis of coronary heart disease（P＜0.05） and R532W mutation in APOB coding gene and diabetes possess negative additive interaction effect in the pathogenesis of coronary heart disease（P＜0.05）. Conclusion The mutation of R532W locus in APOB coding gene of people without lipidlowering therapy before is closely related to TC levels and can reduce the risk of longterm coronary heart disease to a certain extent. The mutation can form positive additive interaction with hypertension and smoking, while form negative additive interaction with diabetes.