The article is devoted to the conditions of applicability of parametric and nonparametric methods, including criticism of frequent methodological errors. By using methods of parametric statistics often make the wrong conclusion that to test the applicability of methods of parametric statistics need to find out whether there are significant differences resulting from the normal allocation of the pilot. Doing this is not necessary, as any encountered in biomedical research component is distributed clearly abnormal. Besides, for the practical application of parametric statistics need sufficient proximity to the source distribution is not normal, and the arithmetic mean from a set of observations. The article stated, under any circumstances and for any amount of observational techniques can be used parametric statistics and how it relates to the value of kurtosis, and what the margin of error calculation of significant differences when using methods of parametric statistics. Subjected to a critical analysis and methods of nonparametric statistics. With their more formal precision and breadth of applicability, however, they checked less valuable statistical hypothesis, as in fact do not work with the values, and their ranks, and the ranking much of the information is lost.

Objective. To determine the prognostic role of the polymorphism of candidate genes for hypertension (HTN) in the effectiveness of antihypertensive therapy in the population of Mountain Shoria, taking into account the ethnic factor. Design and methods. The material for the study was the population of indigenous (Shors) and nonindigenous inhabitants of Mountain Shoria. In the first stage of the study (2013–2017), 901 indigenous people and 508 non-indigenous people were included in the continuous method. A group of patients with HTN was identified — 367 (40,7 %) shors and 230 (45,3 %) representatives of non-indigenous ethnic group. The second stage of the study involved 525 patients with HTN (317 shors, 208 non-indigenous representatives). According to the recommendations of National Guidelines of the Russian Society of Cardiology/the Russian Medical Society on Arterial Hypertension (2010), antihypertensive therapy was prescribed by a cardiologist. A re-examination of patients with HTN included in the prospective stage of the study was carried out after a month, 3 months and 6 months by a paramedic of the local feldsher-obstetric center and after 12 months by a cardiologist. Gene polymorphism ACE (I/D, rs 4340), AGT (c. 803T > C, rs699), AGTR 1 (А1166С, rs5186), ADRB 1 (с. 145A > G, Ser49Gly, rs1801252), ADRA2B (I/D, rs28365031), MTHFR (c. 677C > T, Ala222Val, rs1801133) and NOS 3 (VNTR, 4b/4a) were tested using polymerase chain reaction. Results. In the Shors cohort, the minor allele D of the ACE gene and the favorable allele A of the AGTR 1 gene were associated with a significant decrease in blood pressure (BP) with the 2-component therapy for HTN using blockers of the renin-angiotensin-aldosterone system (RAAS) with a diuretic (odds ratio (OR) = 5,01 and OR = 6,28). The carriage of the mutant allele D of the ACE gene in subjects with the 3-component therapy (RAAS blocker, calcium channel blocker (CCB), diuretic) also determined the achievement of the target BP level (OR = 3,11). In the cohort of non-indigenous nationality, allele A of the AGTR 1 gene was associated with positive dynamics of BP with the use of another combination therapy with a RAAS blocker and CCB (OR = 5,38). Conclusions. Taking into account the ethnicity, genetic characteristics of the patient when choosing drugs is a key point in the effectiveness of therapy in HTN patients. The possibility of using pharmacogenetics in the practice of a cardiologist opens up promising areas and has a great future.

Introduction. A special position among the structural changes of the heart is occupied by left ventricular myocardial hypertrophy (LVH), which refers to the subclinical signs of heart damage in arterial hypertension (AH). Currently, the role of not only demographic, neuroendocrine, but also genetic factors in the development and progression of LVH is no longer in doubt.Aim. To assess the role of clinical and genetic factors in the progression of LVH in patients with hypertension based on the results of a dynamic 5-year follow-up of a cohort of Shors.Materials and methods. The survey of the indigenous population in Gornaya Shoria was carried out in two time periods: onetime (from 2013 to 2017) and prospective (from 2018 to 2020). The study included the adult population (18 years and older) – a total of 901 people – by continuous method. A group of patients with hypertension was identified – 367 people (40.7%). LVH was assessed by electrocardiography and/or echocardiography. The prospective stage of the study included patients with hypertension who had not previously received antihypertensive therapy (263 people). The control and correction of blood pressure numbers was carried out annually, the dynamics of LVH was assessed after five years.Results. Clinical predictors of negative dynamics of LVH were established: obesity (OR = 3.61), abdominal obesity (OR = 4.11), impaired carbohydrate metabolism (OR = 2.83), low high-density lipoprotein cholesterol (OR = 2.05). Genetic markers also demonstrated their involvement in the progression of LVH: allele D of the ACE gene, allele C of the AGTR1 gene, and 4a of the eNOS gene (OR = 9.69; OR = 6.72; OR = 6.37, respectively).Conclusion. The associations of clinical and genetic factors with LVH identified in the Shor cohort can be considered as predictors of myocardial remodeling in hypertension. The data obtained support the hypothesis that polymorphisms of the renin-angiotensin-aldosterone system and endothelial function can influence the phenotype, creating new approaches to the possible prediction of unfavorable outcomes.

The aim of the research. To study clinical and genetic factors predisposing to progression of carotid artery atherosclerosis among the Shor people based on a 5-year dynamic follow-up of hypertensive patients. Material and methods. A prospective clinical and epidemiological study of the indigenous population of the Mountain Shoria was carried out including patients with arterial hypertension (367 subjects). The dynamics of the intima-media complex thickness and atherosclerotic plaque thickness was assessed 5 years later by repeat ultrasound examination of carotid arteries. Polymorphisms of ACE (I/D, rs 4340), AGT (c.803T>C, rs699), AGTR1 (A1166C, rs5186), ADRB1 (c.145A>G, Ser49Gly, rs1801252), ADRA2B (I/D, rs28365031), MTHFR (C677T, rs1801133) and eNOS (VNTR 4b/4a) genes were tested using polymerase chain reaction. Results. The 5-year observation of the indigenous population of the Mountain Shoria has shown that such factors as the age (p=0.011) and the course of arterial hypertension (3rd-degree AH, duration of the disease for over 10 years, failure to achieve the target level of arterial pressure during treatment) play a significant role in the frequent unfavourable dynamics of the intima-media complex thickness. Th e study has also established association between the development of the atherosclerotic process in carotid arteries and smoking (OR=1.52), abdominal obesity (OR=2.87) and impaired glucose tolerance (OR=2.94). The increased level of low-density lipoprotein cholesterol also determines the negative dynamics as manifested by the growth of the atherosclerotic plaque in brachiocephalic arteries (OR=1.93). A high risk of atherosclerosis in the Shor cohort is associated with carriership of the prognostically unfavourable D alleles of the ACE gene (OR=8.29), C of the AGTR1 gene (OR=7.04) and T of the MTHFR gene (OR=3.25). Conclusion. The 5-year prospective observation of the small indigenous population of the Shors has revealed certain clinical and genetic factors for patients with arterial hypertension that are associated with the carotid artery atherosclerosis. The polymorphism of certain candidate genes is an important strategic biomarker that can be used in the future for early diagnostics of diseases associated with atherosclerosis.

Aim. To evaluate the connection of calcium antagonist (amlodipine) therapy with the dynamics of the intima-media complex thickness in patients with arterial hypertension (AH), depending on genetic polymorphism.Methods. The study included representatives of the indigenous nationality (the Shors) – 901 people, of which a group of 367 people with hypertension was identified. The prospective stage of observation included 234 people who did not receive antihypertensive therapy. Based on the prescription of calcium antagonists, patients with hypertension were divided into two groups. Gene polymorphism was tested by polymerase chain reaction.Results. In the Shor cohort, the regression of the intima-media complex thickness of the carotid arteries was observed more often in hypertensive patients who received calcium antagonists if to compare them with those who did not take the drug [OR = 2.30]. In addition, the decrease in the atherosclerotic process is associated with the genotype carriage: I/I of the ACE gene [OR = 9.42], T/C of the AGT gene [OR = 3.52], 4b/4b and 4b/4a of the eNOS gene [OR = 2.26 and OR = 3.75], C/C of the MTHFR gene [OR = 2.62].Conclusion. Pharmacogenetic aspects are valuable from the point of view of an individual approach and obtaining the most pronounced pharmacological response in order to slow down the processes of vascular wall remodeling in patients with hypertension.