Associations between First Year Medical Students’ Lifestyles, Resting Blood Pressure, and Resting ECGs

Philadelphia, PA

Introduction: There is considerable evidence that psychological stressors can impact cardiovascular

health. Medical students experience a high degree of stress based upon their responses to survey questionnaires, although there are few physiological studies that support this association that are targeted specifically to medical students. Medical students in general represent an underrepresented age group in the context of cardiovascular treatment guidelines. Therefore, medical students are a pertinent cohort for study based upon these findings.

Objective:The purpose of this study was to analyze whether medical student lifestyles impact normal baseline cardiovascular measurements of blood pressures and electrocardiograms in this population.

Methods: Twenty five Medical students in the Philadelphia College of Osteopathic Medicine graduating class of 2017 were recruited and met inclusion criteria. Blood pressure and lifestyle factor surveys were obtained on a weekly basis and ECGs were recorded biweekly. All ECGs were read by a cardiologist. Participation by the cardiologist and the subjects was voluntary and without compensation. BP and Heart Rate data were statistically analyzed using ANOVA and the ECG analyses using Fisher Exact Test. Data obtained throughout the study was compared to the subjects’ initial data gathered at the beginning of the academic year. Data was organized into the male gender category, the female gender category, and a category that combined the data for both genders.

Results: There were statistically significant differences in the amount of caffeine consumption and systolic BP abnormalities (p=0.05), and also a statistically significant difference in the amount of strength training exercise and diastolic BP abnormalities (p=0.04) for the male gender category.

There were statistically significant differences in the amount of strength training exercise and prevalence of early repolarization (p=0.01), and the amount of study hours and bradycardia (p= 0.04) for the female gender category.There were statistically significant differences between the amount of aerobic exercise and T wave inversions (p=0.03), anxiety level and voltage criteria for left ventricular hypertrophy (p=0.05), the amount of strength exercise and systolic BP abnormalities (p=0.02), the amount of strength exercise and diastolic abnormalities (p=0.004), the amount of study hours and bradycardia (p=0.034), and the amount of study hours and inverted T waves (p=0.008) for the combined gender category.

Conclusion: Changes in both blood pressure and ECGs in association with both behavioral and curriculum lifestyle factors were demonstrated. Whether the behavioral habits that differed significantly from baseline were due to the curriculum cannot be determined from these preliminary analyses. However, these findings in this population are concerning with respect to younger adults as a discrete and unique population, and may warrant closer scrutiny in conjunction with the American Heart Association Guidelines to determine whether a new category of recommendations for younger adults may be warranted with respect to blood pressure and heart rate parameters.