['Many Eastern Mediterranean countries are undergoing dramatic socioeconomic, demographic and life style changes and face noncommunicable disease (NCD) epidemics. We evaluated recent trends in major NCD risk factors in occupied Palestinian territories (OPT), Turkey, Syria and Tunisia.', 'We searched published and unpublished sources for systolic blood pressure (SBP), diabetes, smoking, body mass index (BMI), and cholesterol trends for both men and women aged 35-84 in each country from 1995 to 2009.', 'Smoking prevalence was stable over time in Tunisia and Syria, but decreasing in Turkey (annual change -0.9%) and OPT (annual change -0.7%). Mean BMI (annual change of 0.1% for Turkey, 0.2% for OPT and Tunisia and 0.3% in Syria) and diabetes (annual change of 0.3% for Turkey, 0.4% for OPT and Tunisia and 0.7% in Syria) prevalence increased in each country. SBP levels increased slightly in Tunisia and Syria but decreased in OPT and Turkey.'] Is cardiovascular risk factor trends in the Eastern Mediterranean region : evidence from four countries alarming?