The Relationship between Academic Stress and Selected Physiological Parameters among Undergraduate Medical Students at Tobruk Medical University, Libya

Abstract

Academic stress is common among university students and is theorised, through activation of the sympathetic nervous system and the hypothalamic–pituitary–adrenal (HPA) axis, to influence cardiovascular and metabolic parameters [1–3]. To examine the relationship between self-reported academic stress and heart rate, respiratory rate, blood pressure, and body mass index (BMI) among university students. A cross-sectional study was conducted in 121 university students. Academic stress was scored on a continuous scale and additionally categorised into low, moderate, and high stress groups. Heart rate, respiratory rate, blood pressure, and BMI were recorded for each participant. The Shapiro–Wilk test was used to assess normality of distribution; as all variables deviated significantly from normality, Spearman’s rank correlation and the Kruskal–Wallis H test were used, with Mann–Whitney U post-hoc comparisons (Bonferroni-corrected) where indicated. Academic stress score correlated significantly and negatively with both blood pressure readings (ρ = −0.568 and −0.474, both p < 0.001), and the high-stress group had significantly lower blood pressure than the low- and moderate-stress groups (all p < 0.001, Bonferroni-corrected). No significant associations were found between academic stress and heart rate, respiratory rate, or BMI (all p > 0.05). In this sample, higher self-reported academic stress was associated with lower rather than higher blood pressure, while heart rate, respiratory rate, and BMI showed no significant relationship with stress level. These findings, which run counter to the classical acute sympathetic stress response, are discussed in relation to the chronic and self-reported nature of the stress measure used and the cross-sectional design of the study.