Global Cardiovascular Risk Profile of Italian Medical Students Assessed by a QR Code Survey. Data from UNIMI HEART SURVEY: Does Studying Medicine Hurt?

Andrea Faggiano,Cesare Tomasi,Gloria Santangelo,Stefano Carugo,Francesca Bursi,Chiarella Sforza,Pompilio Faggiano

doi:10.3390/jcm10071343

Abstract

Background: Few studies to date have addressed global cardiovascular (CV) risk profile in a “protected” young population as that of medical school students. Objective: to assess CV traditional risk factors and global CV risk profile of Italian medical students throughout the six years of university. Methods: A cross-sectional survey accessible online via quick response (QR) code was conducted among 2700 medical students at the University of Milan, Italy. Data on baseline characteristics, traditional CV risk factors, diet, lifestyle habits, and perceived lifestyle variations were evaluated across different years of school. Results: Overall, 1183 students (mean age, 22.05 years; 729 women (61.6%)) out of 2700 completed the questionnaire (43.8% rate response). More than 16% of the students had at least 3 out of 12 CV risk factors and only 4.6% had ideal cardiovascular health as defined by the American Heart Association. Overweight, underweight, physical inactivity, sub-optimal diet, smoke history, and elevated stress were commonly reported. Awareness of own blood pressure and lipid profile increased over the academic years as well as the number of high-blood-pressure subjects, alcohol abusers, and students constantly stressed for university reasons. Moreover, a reduction in physical-activity levels over the years was reported by half of the students. Conclusion and Relevance: This study demonstrates that a “protected” population as that of young medical students can show an unsatisfactory cardiovascular risk profile and suggests that medical school itself, being demanding and stressful, may have a role in worsening of the lifestyle.

Highlights

Current guideline-suggested assessment of cardiovascular (CV) risk profile, based on individual 10-year predicted risk of a CV event, is mainly influenced by age and appears to be unnecessary among young people [1]
As proposed in 1990 by the “Ticking time” theory developed by the San Antonio Heart Study group, atherosclerosis would be the pivotal example of a disease whose process begins many years before its phenotype is fully expressed [2]
It is reasonable that the effect of CV risk factors does not initiate “magically” in adulthood, but that, in a cumulative albeit asymptomatic way, it contributes to vascular damage over the years. In support of this proposition, a brilliant autopsy study conducted on 94 individuals who were deceased at a young age from trauma showed that the severity of asymptomatic coronary and aortic atherosclerosis increases with the number of traditional CV risk factors [3]

Summary

Introduction

Current guideline-suggested assessment of cardiovascular (CV) risk profile, based on individual 10-year predicted risk of a CV event, is mainly influenced by age and appears to be unnecessary among young people [1]. It is reasonable that the effect of CV risk factors does not initiate “magically” in adulthood, but that, in a cumulative albeit asymptomatic way, it contributes to vascular damage over the years In support of this proposition, a brilliant autopsy study conducted on 94 individuals who were deceased at a young age from trauma showed that the severity of asymptomatic coronary and aortic atherosclerosis increases with the number of traditional CV risk factors [3]. Conclusion and Relevance: This study demonstrates that a “protected” population as that of young medical students can show an unsatisfactory cardiovascular risk profile and suggests that medical school itself, being demanding and stressful, may have a role in worsening of the lifestyle

Objectives

Methods

Results

Discussion

Conclusion