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

Abstract Background Medical students are exposed to academic and lifestyle factors that may adversely affect cardiovascular and psycho-emotional health. Although these outcomes have been widely studied, most evidence is cross-sectional, and longitudinal evidence from Latin America remains limited. We described participant retention, baseline characteristics according to follow-up status, and longitudinal changes in cardiovascular and psycho-emotional health in a cohort of Colombian medical students. Methods We conducted a prospective cohort study of first-year medical students from Bogotá, Colombia. Participants completed assessments at enrollment and after entering clinical training. Cardiovascular health was assessed using a study-specific seven-domain modified Life’s Essential 8 (mLE8) framework incorporating dietary, physical activity, nicotine, adiposity, lipid, glucose, and blood pressure domains. Waist-to-height ratio (WHtR) was included as a measure of central adiposity. Psycho-emotional health was assessed using the Trait Meta-Mood Scale-24 (TMMS-24), Interpersonal Reactivity Index (IRI), and Perceived Stress Scale-14 (PSS-14). Baseline characteristics were compared descriptively between completers and non-completers, and longitudinal changes were evaluated using available paired observations. Sensitivity analyses explored the potential influence of missing follow-up data. Results Of 195 students, 97 completed follow-up (49.7%). Baseline characteristics were generally comparable between groups; although completers had slightly higher systolic blood pressure, while non-completers had higher perceived stress and total cholesterol. Among participants with paired observations, median mLE8 decreased from 82.9 at baseline to 75.0 at follow-up, with a median change of − 4.05 points ( n = 88). Concurrently, BMI, waist circumference, waist-to-height ratio, and total cholesterol increased. Perceived stress and most psycho-emotional measures showed little evidence of systematic change. Sensitivity analyses under favorable and unfavorable attrition scenarios yielded negative mLE8 changes, although their magnitude varied. Conclusions In the paired sample, the study-specific mLE8 profile shifted toward less favorable cardiovascular health categories at follow-up, alongside increases in adiposity measures and total cholesterol. However, approximately half of the original cohort was lost to follow-up, and additional variable-specific missingness and the modified nature of the mLE8 construct warrant interpreting these findings as descriptive and exploratory and limiting their generalizability to the entire cohort. Further longitudinal studies with improved retention and more complete data ascertainment are needed to clarify cardiovascular and psycho-emotional trajectories during medical training.