Stress in first-year medical students: a multidimensional analysis of emotional Intelligence, empathy, and cardiovascular health

Background: Medical students face elevated stress and mental health deterioration, driven by academic pressure, financial burden, and burnout. High stress also increases cardiovascular disease risk. In undergraduate systems like Colombia’s, students encounter these challenges earlier, yet few studies assess both psychological and physiological indicators in first-year cohorts. Limited context-specific data further hinders tailored support. This study explored links between perceived stress, emotional intelligence, empathy, and cardiovascular health among first-year medical students in Bogotá. Methods: We conducted a cross-sectional study in which participants completed validated surveys assessing perceived stress, emotional intelligence, and empathy. Cardiovascular health was evaluated using the American Heart Association’s Cardiovascular Health Index (CVHI) and waist-to-height ratio (WHtR). Data analysis included correlation matrices and regression models. Results: Among 195 medical students (62.1% female), 77.6% reported moderate-to-high stress. Although most participants had ideal CVHI scores, poor dietary and physical activity patterns were prevalent. Higher stress levels and less favorable cardiovascular indicators were observed alongside increased age, systolic blood pressure, and waist-to-height ratio. Emotional attention showed a positive association with stress and intermediate CVHI (PR = 5.34), and personal distress was associated with intermediate CVHI, particularly among students reporting elevated stress (PR = 2.52). Conversely, moderate physical activity, greater emotional clarity, and repair were associated with lower stress levels. Conclusions: Clarity, repair, and moderate physical activity appear protective against stress and cardiovascular risk in early medical training. In contrast, high emotional attention and personal distress increased vulnerability. Stress emerged as an important modifier of these relationships, underscoring its central role in student health. These findings support the implementation of locally tailored strategies to enhance emotional regulation and promote healthy behaviors in Colombian medical undergraduates.