Medical students’ cardiovascular health declined during training, but half the cohort was lost

A prospective cohort study of first-year medical students in Bogotá, Colombia, has found that cardiovascular health scores declined between enrollment and the start of clinical training, alongside increases in adiposity measures and total cholesterol. However, the study also highlights a persistent challenge in this type of research: only 97 of the original 195 students completed follow-up, a retention rate of 49.7 percent, which the authors say limits how far the findings can be generalized to the entire cohort.

The research, published in BMC Public Health, enrolled first-year medical students and assessed them at two time points: at enrollment and after they entered clinical training. Cardiovascular health was evaluated using a study-specific, seven-domain modified version of the Life’s Essential 8 framework, covering diet, physical activity, nicotine exposure, adiposity, lipids, glucose, and blood pressure. The researchers used waist-to-height ratio as a measure of central adiposity. Psycho-emotional health was assessed with the Trait Meta-Mood Scale-24, the Interpersonal Reactivity Index, and the Perceived Stress Scale-14.

Among the 88 participants with paired observations at both time points, the median modified Life’s Essential 8 score fell from 82.9 at baseline to 75.0 at follow-up, a median change of minus 4.05 points. At the same time, body mass index, waist circumference, waist-to-height ratio, and total cholesterol all increased. In contrast, perceived stress and most psycho-emotional measures showed little evidence of systematic change over the study period.

Because so many participants dropped out, the researchers compared baseline characteristics between completers and non-completers. The two groups were generally comparable, although completers had slightly higher systolic blood pressure, while non-completers had higher perceived stress and higher total cholesterol at baseline. To probe how missing follow-up data might have shaped the results, the team ran sensitivity analyses under both favorable and unfavorable attrition scenarios. These analyses yielded negative changes in the modified cardiovascular health score in all scenarios, although the magnitude of the change varied depending on the assumptions applied.

The authors are careful to frame the findings as descriptive and exploratory rather than definitive. In their conclusions, they note that approximately half of the original cohort was lost to follow-up, that additional variable-specific missingness affected the data, and that the modified nature of the cardiovascular health construct itself warrants caution. Together, these factors limit the generalizability of the results to the entire cohort of enrolled students.

Longitudinal evidence on cardiovascular and psycho-emotional health during medical training has been limited, particularly from Latin America, where most existing evidence is cross-sectional. The study’s design addressed that gap by following students prospectively through a major transition in their education, the move from preclinical study into clinical training, a period when academic demands and lifestyle patterns may shift substantially.

The pattern observed in the paired sample, a shift toward less favorable cardiovascular health categories at follow-up alongside rising adiposity measures and total cholesterol, suggests that the transition into clinical training coincided with measurable changes in metabolic and anthropometric indicators among the students who remained in the study. The psycho-emotional instruments, by contrast, did not show comparable systematic movement over the same interval.

The researchers emphasize that further longitudinal studies with improved retention and more complete data ascertainment are needed to clarify cardiovascular and psycho-emotional trajectories during medical training. Until such studies are conducted, the changes documented here should be read as an exploratory description of what happened among the students who completed follow-up, not as a settled account of how medical education affects health across an entire entering class.

Subject of Research: Longitudinal changes in cardiovascular and psycho-emotional health among Colombian medical students

Article Title: Cardiovascular and psycho-emotional changes among completers of a medical student cohort with high loss to follow-up

Article References: Céspedes-Londoño, J. A., Sánchez-Sánchez, E., Camacho-Carvajal, T., Rosero-Chamorro, M. J., Guerrero-León, S., Tovar, G., Ladino-Marín, E. V., Briceño, G. D., Tordecilla-Sanders, A., Trompetero-González, A. C., Rodríguez-Parra, J. D., & Ramos-Caballero, D. M. (2026). Cardiovascular and psycho-emotional changes among completers of a medical student cohort with high loss to follow-up. BMC Public Health. https://doi.org/10.1186/s12889-026-29476-6

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29476-6

Keywords: medical students, cardiovascular health, Life's Essential 8, cohort study, Colombia, loss to follow-up, adiposity, cholesterol, perceived stress, psycho-emotional health, Bogotá, public health