Assessing ideal cardiovascular health in medical students
Authors: German-Sallo M , David S Z , Preg Z , Balint-Szentendrey D , Tatar C , Pal T 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
The ideal cardiovascular health concept was defined in preventive cardiology and measured mainly in older adults. However, data about the presence of cardiovascular risk factors in young adults is scarce, especially in our country.

Purpose
To assess the prevalence of cardiovascular risk factors amongst medical students and to estimate their cardiovascular health score.

Methods
In this cross-sectional study, 144 medical students from an East European medical university were enrolled. The inclusion criteria was having total cholesterol and fasting glucose level measured in the last six months. Individuals with chronic diseases were excluded. They filled an online anonymous survey. We applied the seven-metrics cardiovascular health scale developed by the American Heart Association. It defined the presence of four ideal behaviors: abstinence from smoking, normal body mass index, ideal physical activity, and dietary habits, and three ideal health factors: normal blood pressure, absence of hypercholesterolemia and diabetes mellitus. Each item was scored with 0, 1, and 2 corresponding to poor, intermediate or ideal health, consequently the maximal score was 14. We completed this battery with other three cardiovascular risk factors: stress, sleeping habits, and alcohol consumption. The same method was applied to calculate it, the maximal score was 20. We categorized in seven and ten metrics as ideal (10-14 and 16-20 points), intermediate (5-9 and 12-15 points), and poor (0-5 and 0-11 points) cardiovascular health. Age and sex were correlated with risk factors separately using IBM SPSS v.26 and GraphPad Prism 9.1.2.

Results
The mean age was 23.7 years (between 20 and 28 years) and 63.2% (n=91) of the participants were women. Ideal cardiovascular health with seven metrics compared to ten metrics was present in 61% vs. 31%, intermediate health in 30% vs. 57%, and poor health in 9% vs. 12%. Men presented significantly higher body mass index (p=0,0001), higher blood pressure (0,001) but without arterial hypertension, and males consumed more alcohol compared to women (p=0.011). Females experienced significantly more stress (p=0,001), were more frequently smokers (p=0,026) and followed special diets (p=0,013). The prevalence of ideal cardiovascular health was significantly higher in non-smokers.

Conclusions
Our study is the first in our country which evaluated cardiovascular health in medical students. In our sample, the most frequent risk factors were stress, inadequate diet, and alcohol consumption regardless of sex. One of five students had BMI&gt;25 kg/m2, one of four hypercholesterolemia, and one of seven had higher fasting plasma glucose. The addition of stress, alcohol consumption, and sleeping behaviours to the basic evaluation, decreased the prevalence of ideal cardiovascular health almost by half. Based on our results we suggest the inclusion of stress and alcohol consumption in the evaluation of cardiovascular health.