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India is a large and socioeconomically diverse country, and there could be evidence of all the stages of epidemiological transition in the country (Gupta and Gupta, 2009). Ischemic heart disease (IHD) has emerged as an epidemic in India and it is one of the most important causes of mortality and morbidity in the country. It also leads to massive economic burden. Within the Indian subcontinent, a dramatic increase in the prevalence of IHD has been predicted in the next 20 years due to rapid changes in demography and lifestyle consequent to economic development (Dhawan, 1996; Reddy and Yusuf, 1998) (Gupta et al., 2016). The pattern can be seen in the prevalence over a brief period of time varying from 1%-2% in 1960s to 8%-10% in late 1990s (Gupta and Gupta, 1996). IHD epidemiology studies from 1960s to 1990s and reported that IHD prevalence in the country has increased 6 to 9 fold over this period, more in urban than in rural populations (Gupta et al., 2008; Gupta and Gupta, 1996). The main reasons for the increasing rate of IHD are a rising population and the high prevalence of IHD risk factors, with one of the main risk factors being urbanization (Goyal and Yusuf, 2006). Urbanization can characterized by intake of energy dense foods, decreased physical activity, and increased psychological stress which ultimately leads to hypertension and dyslipidemia (Yusuf et al., 2001). The evidence also shows that some ethnic groups may be at particular risk when exposed to an urban environment and also suggests that genetic factors may also be involved. This situation is especially relevant to the experience of Chinese, Malays and Indians residing in Singapore, where Indians have a three times higher rate of myocardial infarction when compared to the Chinese despite their exposure to a similar environment (Lee et al., Risk factors and clinical profile of ischemic heart disease in north India Ashish Akshay Bedi , Ankit Gaur , Sourabh Kosey , Deepanshu Kumar Chitra , Kuldeep Singh , 1 2* 3 1 3