Introduction/Objective: There are more randomized controlled trials concerned with cardiovascular disease than any other disease area. There are also a substantial number of systematic reviews in this area and several pioneers of meta-analysis developed their skills reviewing ischaemic heart disease trials. Currently, individual patient data meta-analyses organised by trialists themselves are being promoted as the best option. I carried out a review of the existing systematic reviews to determine what the scope is for establishing a Cochrane Heart Diseases Review Group.

Methods: I searched the Cochrane Library and Medline for systematic reviews using standard filters to identify reviews and specific terms for different types of heart disease. I searched from 1996 to November 1997.

Results: In all, I found 178 systematic reviews (of which only 7 were based on individual patient data) and only 9 collaborative trialists review groups. Of these, 135 reviews were concerned with various aspects of coronary artery disease (42% acute myocardial infarction). I found no reviews of Chagas Disease, viral cardiomyopathies, valvular heart diseases, or endocardial diseases. I found 26 separate reviews of cholesterol lowering drugs, 19 of calcium channel blocking drugs, 14 of thrombolysis, 11 of antiplatelet drugs, 10 of magnesium. Only 30 (17%) of reviews were concerned with non-pharmacological interventions or surgery.

Discussion: There is considerable duplication of effort by many different research groups. Little attention has been given to heart diseases in poorer countries, valvular heart diseases, congenital heart diseases, the effects of long-established drug treatments in coronary heart disease, or to non-pharmacological interventions. These reviews make an excellent starting point for developing a strategy to determine priorities for Cochrane reviews.