The invention relates to a real-time monitoring system and a method for sudden risk of cardiovascular and cerebrovascular diseases based on pulse wave and human body three-dimensional posture, and belongs to the field of human health monitoring and solves the problem that the existing human health monitoring device can not monitor the sudden risk of the cardiovascular and cerebrovascular diseasesof the wearer in real time. The wearable device acquires the pulse wave data and the three-dimensional gesture data of the human body of the monitored person, and the acquired data is pre-processed through the smart phone and sent to the monitoring background. The monitoring background determines the fatigue degree of the cardiovascular and cerebrovascular system of the monitored person accordingto the three-dimensional posture data of the human body, and selects a corresponding monitoring person's cardiovascular and cerebrovascular disease burst risk prediction model. The model uses the characteristic parameters of the pulse wave as the input object, and outputs the sudden risk value of the cardiovascular and cerebrovascular diseases. The monitoring background sends the burst risk valueof the cardiovascular and cerebrovascular diseases of the monitored person and the corresponding pulse wave data characteristic parameters and the fatigue degree information of the cardiovascular andcerebrovascular system of the monitored person to the intelligent terminal of the monitoring doctor.