The purpose of the review was to study certain aspects of the effect of tobacco smoking on the state of the cardiovascular system, microvasculature in young healthy people and patients with ischemic heart disease. Certain aspects of drug therapy for coronary heart disease in smokers are also considered. Patients and the effectiveness of the use of antianginal drugs from the group of β-blockers. States microcirculatory bed and the effect of tobacco smoking on it by biomicroscopy of the vessels of the bulbar conjunctiva is poorly understood to date.