Objective: The aim of this comparative study was to evaluate the effects of radioactive pollution in river water and confounding risk factors on the prevalence of cardiovascular symptoms in people living in the Ural region. Methods: We selected this region as a case territory for study because it is exposed to chronic ionizing radiation. The area is composed of coastal localities situated along the Techa River, into which liquid radioactive waste materials have been released. As a control, we selected settlements that were not subjected to ionizing radiation. Results: We found a statistically significant relationship between radioactive contamination of a territory and the prevalence of pathologies of the cardiovascular systems of people living in the Techa riverside villages (OR=2.31, p<0.001). The influence of covariates (gender, age, overweight status, and others) on the development of cardiovascular pathologies was analyzed. Some of these factors have been recognized as confounding factors. After accounting for confounding factors, the odds ratio for the impact of radiation on the prevalence of pathologies of the cardiovascular system decreased to (OR=1.58, p=0.02). Conclusions: Statistically significant gender and age differences were observed in the prevalence of pathologies of the cardiovascular system in residents of radioactively contaminated areas compared to residents of control areas. These differences show a more pronounced reaction to contamination in older residents, residents with an overweight status and residents with meteotropic reactions.