Ischemic heart disease (CHD) and chronic obstructive pulmonary disease (COPD) are often manifestations of polymorbid pathology in geriatric patients. According to various authors, 62% of cases among older age groups with COPD revealed cardiovascular diseases, including CHD. The similarity of pathophysiological processes in the formation of hypoxemia, which aggravates the clinical course of both diseases and forms the basis for the development of heart failure, causes interest in the study of intimate mechanisms of disease development and their combined course. The aim of the study was to study the functional state of microcirculation in geriatric patients with IHD and COPD using laser Doppler flowmetry (LDF). Research materials and methods. To achieve this goal, 90 people aged 75 to 89 years with IHD and COPD were examined. The functional state of the microcirculatory bed was evaluated using the lack-02 blood microcirculation analyzer (LAZMA, Moscow). The study of basal blood flow and changes during the occlusion test was performed. The study of external respiratory function (FVD) was performed on a spirograph Spirolab II (Medical International Research, Italy) with automated parameter processing. Results. In geriatric patients with IHD and COPD, violations of the functional state of the microcirculatory bed are determined, progressing with an increase in the degree of COPD. Pathological changes are characterized by a decrease in the density of the capillary network, the deterioration of vasomotor activity of smooth muscle cells in precapillary link of the microvasculature, increased intravascular resistance, which leads to stiffening of the vascular wall. In patients with polymorbidity, pathological types of microcirculation are formed, indicating a functional and structural discharge of the microcirculatory network. Conclusions. Age is a predictor of hypoxia and vascular remodeling. In the combined course of IHD and COPD, there are more pronounced violations in the capillary blood flow. Syntropy of diseases, together with hemostatic disorders that occur during aging, causes a high risk of complications in geriatric patients.