Stress, Autonomic Reactivity and Blood Pressure among Undergraduate Medical Students

Medical training is highly stressful particularly for those who are beginning their medical education. The present study was undertaken to find out the level of stress, hypertension and its etiological factors among undergraduate medical students. METHOD: One hundred and seventeen undergraduate medical students between 17-21 years of age got examined for blood pressure and stress level. Twelve hypertensives selected from the above subjects and twenty normotensives underwent cold pressure test to assess autonomic reactivity to laboratory induced stress. RESULTS: 10.25% of the subjects were found to be hypertensive and 6.83% pre hypertensive. On the stress scale 53% had mild stress, 7% showed moderate stress while none had stress as a major problem. There was no correlation between BP and stress score. On CPT, BP increased significantly in both the hypertensive and normotensive group but came back to basal levels within 5 minutes indicating normal autonomic response. Rise of BP was higher in hypertensive group. The diastolic and mean BP increased significantly on CPT in subjects having family history of hypertension. The subjects taking more of junk and oily foods had a higher systolic BP. Forty percent of normotensive subjects had more than 20 mm Hg rise in systolic BP on CPT. CONCLUSIONS: Adolescents must be routinely screened to detect asymptomatic hypertension. Advice on risk factor modification by appropriate lifestyle changes may prevent long term effects of hypertension on target organs. Keywords: autonomic reactivity, blood pressure,  cold pressor test, medical students, stress.