Permanent residence in extreme climatic and geographical conditions provides the stress of adaptation reserves of the whole human body and the work of homeostatic systems in the new conditions. The aim of the study was to analyze the frequency of atherosclerosis risk factors and their relationship with coronary heart disease (CHD) in elderly and senile men living in Far North. Methods. An analytical study of the frequency of metabolic risk factors of atherogenesis was conducted among men (n = 505) with verified coronary heart disease (case group, n = 244) and without signs of coronary heart disease (control group, n = 261) 60 years and older, living in Far North, taking into account age and ethnicity. To assess the results of the study, the odds ratio (OR) and 95 % confidence intervals for OR were calculated. Results. High cardiovascular risk was noted in the group of patients with coronary artery disease compared with the group of patients without coronary artery disease (p < 0.001). Patients with coronary artery disease haв higher body mass index, waist-to-hip ratio, and blood pressure. In the absence of significant differences in the content of total cholesterol, the lipid profile in men with coronary heart disease haв more atherogenic nature (p < 0.001). When ethnicity was taken into account, a relationship was found between smoking, arterial hypertension, central type obesity and an increased risk of coronary heart disease among non-indigenous men (p < 0.001). A more favorable metabolic profile was noted in male indigenous ethnic groups (the Yakuts). Conclusions. A comparative analysis of the risk factors of coronary heart disease revealed high rates of hypertension and obesity in the group of patients with coronary heart disease living in extreme conditions of the Far North, in comparison with the control group without ethnicity, while hypercholesterolemia was more often observed in the Yakut group, and hypertriglyceridemia and smoking in a non-indigenous ethnic group (p < 0.001).