Objectives The frequency of cardiovascular diseases has increased throughout the world. People of African descent have been disproportionately affected, particularly if they reside in urban settings. In this work, we evaluate risk factors associated with cardiovascular diseases (CVD) and other chronic diseases in rural and urban Afro‐derived communities (quilombo) in Central Brazil. We also determine if there are associations between the frequency of CVD risk factors, sex, and proximity to urban environments. Methods Through a cross‐sectional study of participants (n = 347) within three Brazilian Afro‐derived communities: Kalunga (a semi‐isolated rural community; n = 214), Cocalinho (a non‐isolated rural village; n = 70), and Pé do Morro (an urban community; n = 63), we collected data regarding chronic disease (i.e., CVD, diabetes, and hypertension) risk through questionnaires, anthropometrics, blood pressure, and blood samples using standard protocols. Differences between variables were tested by the Chi‐square test of Pearson and Fisher's Exact Test, independent sample t‐tests, analysis of variances, and Kruskal‐Wallis tests (p ≤ .05). Results The prevalence of hypertension, overweight, obesity, and other cardiovascular risk factors were higher in the non‐isolated rural and urban communities than in the semi‐isolated rural community. We found significant sex differences in the distribution of the CVD risk factors, with all occurring at a higher frequency among females. Conclusions Our findings indicate that Brazilian Afro‐derived communities are currently going through an epidemiological transition. The urban lifestyle and its environmental factors are likely contributing to an escalation in cardio‐metabolic disease risk. However, the magnitude of this transition differentially impacts the sexes, as females suffer a higher frequency of risk factors compared to males.