Atherosclerotic cardiovascular disease is the major cause of death in our country and occurs at earlier ages than that observed in the United States of America 1,2 .The initial results of the Framingham Study have associated serum cholesterol level, smoking, and arterial hypertension with ischemic heart disease 3 . More recently, the National Cholesterol Education Program (NCEP III, USA) 4 published the recommendations for estimating absolute coronary risk, considering the total cholesterol level, age, HDL-C level, values of systolic and diastolic blood pressure, and smoking habit, with different scores for men and women.In the past decade, several studies suggested that a more active lifestyle and higher consumption of fish could be beneficial, because they resulted in a lower incidence of cardiovascular events, a better lipid profile, and a reduction in blood pressure and in thrombotic risk [5][6][7][8] .Among the Eskimos in Greenland and the Japanese of Kohama Island, lower levels of total cholesterol and triglycerides and an extremely low incidence of coronary heart disease were observed as compared with those in the populations living on the continent 9-11 .In Brazil, epidemiological data of the Ministry of Health for the City of Belém, in the State of Pará 12 , showed that mortality due to cardiovascular disease was the major cause of death in that city despite the proximity to rivers and forests, and the high consumption of fish and typical fruits in that region.This study aimed at comparing the cardiovascular risk of the urban population of Belém in the State of Pará with that of an Amazonian riverside population (village of Vigia) living mainly on fish and with very scarce contact with large urban centers. MethodsThe study sample comprised 100 individuals of both sexes with no personal antecedents of heart disease or diabetes, whose ages ranged from 35 to 65 years, 50 in each municipality. They signed a written consent required by the Objective -To compare the lipid profiles and coronary heart disease risks of 2 Brazilian Amazonian populations as follows: a riverside population (village of Vigia) and an urban population (city of Belém in the state of Pará).Methods -Fifty individuals controlled for age and sex were assessed in each region, and the major risk factors for coronary heart disease were analyzed. Results -According to the National Cholesterol Education Program (NCEP III) and using the