What must we know about cardiovascular prevention in medical school freshmen?

Type of funding sources: None.

Background/Introduction. Medical students have been found to report high levels of perceived stress that may be influenced on health status and academic performance. Digital era and e-learning produce novel risk factors for cardiovascular disease (CVD) including arterial hypertension. In real life clinical practice in large healthy populations it is quite difficult to follow guidelines for hypertension screening due to the time deficit.

Purpose. The aim of the study was to examine prevalence of CVD risk factors and impact of casual blood pressure on cognitive function in 1st and 6th year medical male students.

Methods. Cross-sectional study was conducted during the period from 2014 to 2020. 222 first year (age (M ± m) 18.5 ± 0.1 years) and 207 6th year male medical students (age 23.5 ± 0.3 years) completed 45-item questionnaire about habitual life-behavior and performed 9 cognitive tasks. Blood pressure (BP) was self-measured by electronic device just prior to testing.

Results. In freshmen mean body height was (M ± m) 180.3 ± 0.5 cm; weight – 76.8 ± 1.1 kg, body mass index (BMI) – 23.6 ± 0.3 kg/m2; heart rate – 82.1 ± 0.9 bpm; casual systolic BP (SBP) -131.9 ± 2.3 and diastolic BP (DBP) – 77.6 ± 0.6 mm Hg. 6th year male students had similar height (179.6 ± 0.5 cm), but were heavier (80.5 ± 1.0 kg; p < 0.01; BMI =24.9 ± 0.3 kg/m2; p < 0.01). Heart rate (78.7 ± 0.8 bpm; p < 0.05) and casual SBP (126.7 ± 0.8 mm Hg; p < 0.05) were lower. No difference was found in DBP (77.8 ± 0.6 mm Hg).

Excessive body weight was detected in 16.6 % of 1st and in 36.2 % of 6th year students, obesity – in 8.5 and 6.8 % of students. 3 first year males and 1 – from 6th year group had morbid obesity (BMI > 40.0). Low physical activity reported 22.1% and 29.9%. Current smokers were 16.1 % of 1st and 33.3 % of 6th year students, but only 9.4 and 18.8 % smoked permanently. Casual SBP lay in high normal range in 27.4 % of 1st and in 34.3% of 6th year, and above 140 mm Hg – in 21.5 and 14%.

Correlation analysis revealed in both groups significant positive correlations SBP and DBP to weight and BMI, SBP to height (p < 0.05) and screen time (p < 0.01) and DBP - to heart rate. Only in freshmen SPB was related to cognitive functions: 17-18 year’s ones with elevated BP made tests faster may be due to their greater arousal, whereas 19-20 year’s – slower, but had better working vision memory. Only in 17-18 year group existed negative association SBP to subjective vision value and smoking status.

Conclusions. Modern medical male students are at high risk of CVD: casual BP within the normal range was only in 49 % of 1st and in 48 % of 6th year students, 25 % of freshmen and 43 % of 6th year males were overweight or obese, and one quarter was physically inactive. Besides healthy lifestyle and nutrition promotion quite necessary is also to limit screen time.