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The aim of this study was to develop means for in vivo quantitative assessment of the degree of red blood cells aggregation in the microcirculation bed by optical capillaroscopy, which is particularly important for patients suffering from cardiovascular diseases, with the goal of in vi-vo identification of diagnostically significant markers using machine learning methods. Quantita-tive assessment of red blood cells aggregation parameters in nail-bed capillaries was performed using optical capillaroscopy and, for comparison, in whole blood samples by laser diffuse scat-tering aggregometry. The results of our study showed the presence of red blood cells aggregates in nail-bed capillaries of patients suffering from hypertension, coronary artery disease, and atrial fibrillation compared to healthy people who do not have red blood cells aggregates in their capil-laries. This correlated with elevated red blood cells aggregation measured in vitro in whole blood samples To conclude, these results open up new opportunities for early non-invasive in vivo assess-ment of the red blood cells microrheologic alterations, which happen in patients suffering from many socially important diseases. This work was supported by the Russian Science Foundation (Grant № 23-45-00027).