The current data on some molecular cellular and molecular genetic mechanisms of atherosclerosis and its complications have been presented in the research. Taking into account the significance of lipid transport system for initiation of atherosclerosis plaques we point to major role of lipoprotein modified forms in atherogenesis. Information of key mediators of macrophage transformation into foam cells has been produced. The results of original investigation of some genes’ polymorphism analysis in ethnic groups in Siberia and its connection with ischemic heart disease have been represented.