Objectives. To compare the estimation of coronary heart disease (CHD) risk by the Framingham risk score (FRS) and the Copenhagen risk score (CRS) using Dutch population data. Design. Comparison of CHD risk estimates from FRS and CRS. CHD risk-estimations for each separate risk factor. Setting. Urk, the Netherlands. Subjects. A total of 408 fishermen from Urk, aged 30-65 years, without pre-existing cardiovascular disease. Main outcome measures. Absolute CHD risk estimates. Results. The average 10-year risk for CHD was significantly different between the FRS (4.6%, SD 5.0) and the CRS (3.2%, SD 4.1). The correlation between the two estimates was 0.94 (P <0.001). The Bland-Altman figure shows a large proportion of agreement, but with an increasing difference with increasing average risk. When examining the separate risk factors age, total cholesterol, HDL cholesterol and systolic blood pressure and smoking, there appear differences between the two risk functions. Conclusion. Using Dutch population data, differences were found for the calculation of CHD risk with the FRS and the CRS. Further research must be carried out to examine the validity of these risk functions in the Dutch population.