The heart, serving as the "energy factory" of the human body, is tasked with the critical mission of maintaining blood circulation and oxygen supply,Therefore, its normal functioning relies on the generation of a substantial amount of ATP to support its mechanical activities.. However, under pathological conditions such as myocardial infarction, coronary artery sclerosis, and pulmonary hypertension, insufficient blood supply leads to a reduction in oxygen supply, subsequently activating a series of compensatory protective mechanisms. ,Hypoxia-inducible factor-1α (HIF-1α), a nuclear transcription factor stably expressed under hypoxic conditions,, has been proven to regulate oxygen transport by promoting angiogenesis and vasodilation, and optimize oxygen utilization by regulating the balance of glucose metabolism and lipid metabolism, participating in the regulation of various cardiac diseases. HIF-1α plays a crucial role in regulating cardiac energy metabolism and oxidative stress. This article systematically summarizes the various mechanisms of action of HIF-1α in reprogramming cardiac energy metabolism, combines the latest research results, deeply explores its potential clinical application value in cardiovascular diseases, and proposes future research in directions and possible treatment strategies. By comprehensively summarizing the mechanism of HIF-1α in ischemic heart disease, this article aims to provide new ideas and therapeutic targets for the prevention and treatment of cardiovascular diseases. [Key words] HIF-1α;hypoxia;lipid metabolism;glycolysis;oxidative stress