Abstract Body: Introduction: Delay discounting, a behavioral index of choice impulsivity, is associated with unhealthy behaviors, cardiovascular risk, and adverse psychoemotional outcomes. Stress may influence these associations, yet evidence in medical students who face sustained academic and psychosocial demands remains limited. We examined whether higher delay discounting is associated with adverse cardiovascular and psychoemotional profiles and whether perceived stress modifies these relationships.
Methods: A cross-sectional study of first-year medical students in Colombia (2019–2020). Cardiovascular profile was assessed using the AHA Life’s Simple 7 and traditional metrics and Psychoemotional health using validated scales to measure stress, emotional intelligence, and empathy. Choice impulsivity was quantified with a computerized delay discounting task, in which students were asked to share between smaller sooner and larger delayed monetary rewards. Univariate and multivariate linear regressions were used.
Results: 172 participants (62.2% female; median age 18 years), in univariate analyses, waist circumference correlated with the computational measure of impulsivity, the discount rate (β=0.22; 95% CI 0.00–0.44; p=0.049). In multivariable models, higher discount rate was associated with systolic blood pressure (β=0.60; 0.24–0.96; p=0.001), waist circumference (β=2.02; 1.31–2.73; p<0.001), and the perceived stress score (moderate vs low β=3.54; p<0.001; high vs low β=4.32; p=0.045), personal distress (β=1.70; 0.37–3.04; p=0.013), and moderate physical activity (β=1.01; 0.33–1.70; p=0.004). Age was inversely associated (β=−0.41; −0.69 to −0.12; p=0.006).
Conclusions: Higher levels of perceived stress are associated with higher choice impulsivity and worse cardiovascular health indicators. Given the young age of this sample of medical trainees, this finding underscores the importance of early preventative interventions aimed at protecting this vulnerable population’s health. Furthermore, in addition to its direct adverse effects on cardiovascular health, stress may operate as a contextual modifier of impulsive decision-making, further worsening cardiometabolic vulnerability through maladaptive behavioral mechanisms. m. We recommend embedding stress-management and physical-activity programs in medical training programs and conducting longitudinal trials to test the effect of these interventions on delay discounting and cardiometabolic markers.