Digital pharmacoepidemiology of angiotensin-converting enzyme inhibitors in Russia

Hypertension remains one of the leading causes of cardiovascular morbidity and mortality; however, patient adherence to treatment remains inadequate. In the context of a digital society, search queries can serve as an additional source of information regarding the population's information needs and patterns of interaction with medications.

To conduct a comprehensive longitudinal infodemiological study of the Russian population's interest in angiotensin-converting enzyme (ACE) inhibitors based on an analysis of search queries for the period 2018-2025.

A retrospective study was conducted using aggregated data from the Yandex search engine (Wordstat) covering 84 months. Search queries were analyzed for six major ACE inhibitors (captopril, enalapril, lisinopril, perindopril, ramipril, fosinopril), as well as for their brand names (21 drugs in total). We analyzed time series (Mann-Kendall test), seasonality (Kruskal-Wallis test), and variability, as well as performed multidimensional semantic analysis (Latent Dirichlet Allocation (LDA), Term Frequency-Inverse Document Frequency (TF-IDF) + k-means, k-medoids, n-grams).

The total volume of analyzed queries exceeded 102 million. The greatest informational interest was identified for the captopril (30.1% of all queries), perindopril (27.9%), and enalapril (21.3%) groups. Perindopril demonstrated the strongest positive trend (τ = 0.762; p < 0.001). Statistically significant seasonality (p < 0.05) was observed for all six main International Nonproprietary Names (INN), with a peak during the winter months and a decline in activity during the summer. Semantic analysis revealed distinct differentiation in information patterns: captopril was associated with emergency use and sublingual administration, enalapril with manufacturer selection, lisinopril with searches for instructions and reviews, and perindopril with fixed-dose combinations. The proportion of queries related to emergency use was highest for captopril (0.53%) and lowest for the other drugs.

Users' search activity reflects consistent differences in the perception of ACE inhibitors and demonstrates pronounced seasonal dynamics. The identified digital patterns may indirectly reflect medication-related information needs and potential gaps in the population's health literacy. The infodemiological approach represents a promising tool for monitoring patients' information needs and optimizing clinical communication and preventive programs.