Aim To investigate the effects of metoprolol succinate sustained-release tablets on heart rate turbulence(HRT) and heart rate variability(HRV) to silent ischemia with coronary heart disease. Methods The changes of heart rate turbulence and heart rate variability to silent ischemia with coronary heart disease in treatment with metoprolol were investigated. Results The TS and TO in treatment group were both lower than those of control group(P<0.05).The TS and TO after treatment were higher than those of before treatment.SDNN,SDANN and SDNNindex before treatment in treatment group except rMSSD and PNN50 were lower than those of control group(P<0.05).SDNN,SDANN and SDNNindex after treatment in treatment group were increased significantly(P<0.05). Conclusion HRT and HRV in the patients of silent ischemia with coronary heart disease is abnormal and metoprolol can improve the heart autonomic nerves function.