Steca et al. also found a significant relationship of illness severity with health satisfaction and depression in cardiovascular disease patients, but these relationships were fully mediated by illness perception and self-efficacy beliefs. Therefore, as mental disorders are frequently comorbid with cardiovascular disease and stroke, whether these two diseases influence the HRQoL directly or indirectly through some other mediators, such as psychological functions, requires further Angeloyl-gomisin-H evaluation. The purpose of this study is trying to determine how psychological factors affect the link between cardiovascular disease and stroke with the HRQoL. Additionally, the impacts of these diseases on the HRQoL will also be evaluated. In this study, we found that cardiovascular disease and stroke are both negatively associated with health related quality of life through different pathways. The cardiovascular disease influences the MCS and PCS both directly and indirectly through anxiety. On the other hand, with a direct effect on both kinds of HRQoL, stroke also has an impact on MCS and PCS mediated by depression indirectly. These results provide an evidence to clarify the possible underlying mechanisms between HRQoL and cardiovascular disease and stroke. Depression and anxiety are common comorbidities in patients with cardiovascular disease and stroke.. There are several assumptions for such high prvalence. First, both depression and anxiety have been proposed to be the risk factors or preictors of cardiovascular disease and stroke. Second, cardiovascular disease and stroke may also precipitate the development of depression and anxiety through biological and behavioral mechanisms. From biological aspects, Hare et al. have summaried the possible mechanisms of post-cardiovascular disease depression, which included alterations in the autonomic nervous system, platelet receptors and function, coagulopathic factors, pro-inflammatory cytokines, endothelial function, neurohormonal factors, and genetic linkages. Feng C. also reviewed the possible neurobiological pathogenesis for post-stroke depression, which included neuroanatomical factors, neuronal biochemical factors, and neurogenesis Chamigrenal hypothesis.