Objective:To analysis the predictive value of peripheral blood T-helper cells (Th17), regulatory T cells (Treg) and Th17/Treg in patients with rheumatoid arthritis (RA) comorbid cardiovascular disease.Methods:A total of 180 RA patients treated in Honghu Hospital of Traditional Chinese Medicine from January 2022 to January 2023 were selected retrospectively, they were divided into comorbidity group (72 cases) and RA group (108 cases) according to whether they had cardiovascular disease. The general data of patients were collected, the levels of peripheral blood Th17, Treg were measured by flow cytometry, the Th17/Treg ration was calculated. The risk factors of RA comorbid cardiovascular disease were analyzed by binary Logistic regression, and the predictive value of Th17 and Treg for RA comorbid cardiovascular disease was analyzed by the receiver operating characteristic (ROC) curve.Results:The levels of male proportion, uric acid, Th17, Th17/Treg ratio were increased, and Treg were decreased in the comorbidity group compared to the RA group: 63.89%(46/72) vs. 44.44%(48/108), 350.00(288.00, 404.50) μmol/L vs. 316.00 (257.50, 382.50) μmol/L, (11.28 ± 4.22)% vs. (6.60 ± 2.98)%, 3.55 ± 6.53 vs. 1.48 ± 2.54, (5.10 ± 2.19)% vs. (6.75 ± 2.86)%, there were statistical differences ( P<0.05). Binary Logistic regression analysis showed that Th17 and Th17/Treg ratio were risk factors for RA comorbid cardiovascular disease, and Treg cell ratio was a protective factor for RA comorbid cardiovascular disease (all P<0.05). The area under the curve (AUC) predicted by Th17 and Th17/Treg for RA comorbid cardiovascular disease were 0.814 and 0.785, respectively. The AUC predicted by Th17 for RA comorbid coronary heart disease, ischemic stroke and peripheral atherosclerosis were 0.804, 0.832, and 0.784, respectively. The AUC predicted by Th17/Treg for RA comorbid coronary heart disease, ischemic stroke and peripheral atherosclerosis were 0.763, 0.792, and 0.883, respectively. Conclusions:Th17, Treg and Th17/Treg are the possible influencing factors of RA comorbid cardiovascular disease, and Th17, Th17/Treg have a certain predictive value for RA comorbid cardiovascular disease.