Effects of Stress and Stress Hormones on Heart Rate Variability Parameters in 1st Year Medical Students

Abstract

Stress in present world is inevitable where each individual in pursuit of achieving the maximum undergoes through this event. stress in medical education has resulted in decreasing the confidence of students and cause of various abnormal psychological conditions. Anxiety induced stress is common and this exaggerates during the time of examinations. This altered state of mind results in variation of heart rate variability indices and biochemical parameters which needs to be examined. The present study attempts to correlate stress with biochemical and HRV parameters. The present study inducted first year medical graduate course students after obtaining informed consent. 30 students participated in the study among them 18 were male and 12 female students with mean age of 17.9±0.55 years The students were subjected for 5minute recording of ECG under standard conditions for heart rate variability parameters. The recording of these parameters was done once when the students joined the course and the second recording was obtained after 6 months when the 2ndInternal examination Viva-voce were conducted similarly for evaluation of the biochemical physiological stressors was evaluated by collecting 5ml of venous blood and subjected to serum cortisol and uric acid levels analysis immediately using Fully automated Bidirectionally Interfaced Chemi Luminescent Immuno Assay for cortisol and Photometry for uric acid levels twice when the recording of heart rate variability (HRV) was done. Results were subjected to statistical analysis using statistical software sPss 20.0. students ”t” test and Pearson's tests were done. A p value of <0.05 was considered to be statistically significant. Our results showed correlation of uric acid levels with time domain parameters of heart rate variability and LF/HF ratio of frequency domain. The cortisol levels could not directly link with heart rate variability parameters. Serum cortisol and uric acid levels are good indicators for determination of stress as demonstrated in our study of academic environment. Though we could establish uric acid levels correlating with decrease in short term recording of heart rate variability parameters. We would suggest further studies with larger sample size and recordings during university examinations which would predict its usefulness. We suggest academic stress can lead to chronic illness and thus detoriate the quality of life lead by health professionals. Hence we suggest early intervention and change curriculum as well as evaluation process which can reduce the stress perceived by students.