Ethnicity as a model for the development of cardiovascular diseases and their risk factors in epidemiological studies

Aim. To assess the indigenous small population of the Shor people in terms of the ethnic-specific development of cardiovascular diseases and their risk factors during the epidemiological studies in the Mountain Shoria.

Methods. The study was carried included the indigenous and non-indigenous population of the Mountain Shoria during two different time periods: the first period (1998–2002) — 1215 people (550 indigenous Shors and 665 non-indigenous people) and the second period (2013–2017) — 1409 people (901 and 508, respectively). The prevalence of cardiovascular risk factors, arterial hypertension (AH) and ischemic heart disease (CHD) was studied. In the second period of the study, the genotype frequencies of the genes ACE (I/D, r 4340), AGT (c.803T>C, rs699), AGTR1 (A1166C, rs5186), ADRB1 (c.145A>G, Ser49Gly, rs1801252), ADRA2B (I/D, rs28365031), MTHFR (c.677C>T, Ala222Val, rs1801133) and NOS3 (VNTR, 4b/4a) and their associations with arterial hypertension were identified. There was data on organ damage obtained among patients with high blood pressure (left ventricular myocardial hypertrophia, carotid arteries intima-media complex thickening, albumin level).

Results. The first period of the studies showed that the Shors differed from the incoming population in an extremely low prevalence of lipid metabolism disorders, obesity, and an almost complete absence of diabetes mellitus. At the same time, there was a high prevalence of tobacco smoking and alcohol consumption. The second period of the studies demonstrated significant differences between different ethnic cohorts according to the “genetic passport” towards a more favorable profile among the indigenous people. However, the Shor people with arterial hypertension had a more severe course of hypertensive disease, defined as frequent organ damage. In addition, the “profile” of a patient with coronary heart disease differed depending on the place of residence, in urban or rural. Epidemiological studies contribute to the acquisition of new knowledge about different ethnic groups, their lifestyles and agricultural practices, regions of residence, and the features of candidate gene polymorphism. This provides valuable material for individualizing the prevention and treatment of diseases.

Conclusion. Ethnicity makes adjustments to the patient's profile; understanding the ethnic specificity allows developing targeted preventive measures, thereby preserving the people’s health.