The deteriorating trend of life expectance since the mid 1970s, mainly due to higher cardiovascular mortality in the East compared to West Germany, requires explanations about what happened to the cardiovascular risk factor profile in the East. Epidemiologic studies in the East German population have been performed for about 25 years and can justify a first answer to the question, whether the opening gap in life expectancy could be attributable to a deteriorating cardiovascular risk factor profile of the 25-64 year old population. During a review process reliable epidemiological studies in the East German population have been identified to describe sequential changes from 1968 to 1992 in systolic and diastolic blood pressure (SBP, DBP) total cholesterol (CHOL), body mass index (BMI) and cigarette smoking in five periods of time. The mean SBP increased in males of higher age groups, whereas it dropped in females in all age groups in this period of time. The mean CHOL showed a striking increase in both sexes and levelled off in the mid 1980s only. The mean BMI increased slightly in men of the middle age groups and remained almost unchanged in women. The prevalence of cigarette smoking increased in both sexes until the 1970s, and declined thereafter in the age groups over 40, however, there is an increasing tendency in young age groups and females after the wall came down. These trends are congruent with the hypothesis, that the increasingly unfavourable trend of life expectancy in East Germany (compared to the continuously improving trend in West Germany) is at least partly attributable to the trend of the cardiovascular risk factor profile.