Systematic Review

  • The search for studies in the literature was comprehensive and systematic and sought to reduce the risk of bias and to identify as much relevant evidence as possible;

  • The search strategy was designed to maximize sensitivity (comprehensiveness) while seeking reasonable accuracy, given the breadth of the thematic and geographic approach for review (cardiovascular diseases in Brazil);

  • An overall literature search strategy will be developed to describe the main terms and concepts used in all or in most of the chapters. These main concepts were divided into three blocks: the first, including cardiovascular diseases; the second, with terms related to epidemiology, prevention and control, costs, genetics/family history and global burden; the third, with terms related to Brazil, its states and cities. In other words, the objective was to recover studies that simultaneously presented one or more terms for each concept;

  • The search strategies for each individual chapter were built upon the overall strategy, and refined as needed, according to the authors’ expertise;

  • Search was conducted on MEDLINE via PubMed, Embase, Cochrane Library, CINAHL, Scopus, Web of Science and LILACS. Ongoing studies and unpublished data were also included in the review. There was also manual search and examination of the reference lists of the included studies as well as other relevant systematic reviews;

  • There was no restriction on publication status or language. In some searches, depending on the volume of published literature, publication type limits were added. In this case, filters validated by type of study were used to recover those with a higher level of evidence. Considering the scope and objective of the review, the literature search focused on publications from the last 15 years;

  • To ensure search consistency, the same terms and descriptors were used on all search strategies (customized according to the specificities of the database). The controlled vocabularies MeSH, Emtree and DeCS were used to develop the search strategies. The terms were exploded whenever appropriate, so as not to miss relevant studies. In order to ensure a comprehensive search, a wide variety of free terms were included (considering, for example, spelling variants, synonyms and acronyms);

  • The selection process was managed through EndNote;

  • Study eligibility evaluation was based on the screening of articles, by reading their titles and abstract (when available), and a confirmation procedure, by reading the full manuscript;

  • The report on the search, evaluation, selection and synthesis of evidence followed the PRISMA recommendation.


The following flow diagram shows the selection process for the studies included in the review of all cardiovascular diseases in Brazil: