Introduction: Habitation and the process of adaptation of the population of northern regions to the harsh environment are associated with the development of such syndromes and conditions as polar tension, polar dyspnea, the polar metabolic type, premature aging, and north-related hypertension, and aimed at maintaining homeostasis constancy to ensure full life activity in extreme environmental conditions, it which issues of preserving human health and labor potential remain highly relevant. Objective: To review published data on physiological and genetic adaptation to adverse climate and environmental stressors and to establish informative genetic markers for assessing adaptabilities of northerners. Materials and methods: The review includes data of Russian and foreign studies published in Russian and English languages in 1980–2021 and cited in the Pubmed, NCBI, eLIBRARY.RU, Scopus, Web of Science, and RSCI databases. Of 330 articles found, 40 full-text materials were selected for this review based on the following criteria: availability of data on polymorphic variants of genes involved in the genetic adaptation of humans to extreme conditions of the north; availability of data on epidemiology of genes associated with multifactorial diseases most common in the circumpolar zone; availability of data on adverse health effects of environmental factors in northerners, and ethnic features of gene pools of indigenous people and newcomers of the circumpolar zone. Methods of information analysis were applied to summarize the results of studies reviewed. Results: A strategy for assessing the level of functional reorganization of the human organism in the North is proposed. The article also describes a panel of informative genetic markers selected for a comprehensive assessment of adaptability of northerners, including, inter alia, normal genetic variability of adapting people, with the purpose of creating region-oriented diagnostic maps allowing assessment of total risks of cold-related illnesses for timely correction of the lifestyle and taking preventive and therapeutic measures. Discussion: In the genetic and epidemiological study of human populations living in extreme environments, it is expedient to use a comprehensive approach that includes personalized, preventive and predictive assessment of medical, psycho-physiological and genetic determinants of the functional state matrix, reflecting the current level of adaptation of northerners.
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