Increasing utility of Google Trends in monitoring cardiovascular disease

Introduction: Cardiovascular disease is the most common cause of morbidity and mortality in the United States. Patients are increasingly using internet search to find health-related information, including searches for cardiovascular diseases and risk factors. We sought to evaluate the change in the state by state correlation of cardiovascular disease and risk factors with Google Trends search volumes. Methods: Data on cardiovascular disease hospitalizations and risk factor prevalence were obtained from the publically available Centers for Disease Control and Prevention website from 2006 to 2018. Google Trends data were obtained for matching conditions and time periods. Simple linear regression was performed to evaluate for an increase in correlation over time. Results: Hospitalizations for six separate cardiovascular disease conditions showed moderate to strong correlation with online search data in the last period studied (heart failure (0.58, p <.001), atrial fibrillation (0.57, p <.001), coronary heart disease (0.58, p <.001), myocardial infarction (0.70, p <.001), stroke (0.62, p <.001), cardiac dysrhythmia (0.46, p <.001)) in the United States. All diseases studied showed a positive increase in correlation throughout the time period studied (p <.05). All five of the cardiovascular risk factors studied showed strong correlation with online search data; diabetes (R = 0.78, p <.001), cigarette use (R = 0.79, p <.001), hypertension (R = 0.81, p <.001), high cholesterol (R = 0.59, p <.001), and obesity (p = 0.80, p <.001) in the United States. Three of the five risk factors showed an increasing correlation over time. Conclusion: The prevalence of and hospitalizations for cardiovascular conditions in the United States strongly correlate with online search volumes in the United States when analyzed by state. This relationship has progressively strengthened or been strong and stable over recent years for these conditions. Google Trends represents an increasingly valuable tool for evaluating the burden of cardiovascular disease and risk factors in the United States.