Background: The transition from adolescence to adulthood is a highly susceptible period for increased cardiovascular disease (CVD) risk, due in part, to emerging self-reliance and its associated stressors. We examined the association between psychological distress and established CVD risk factors among university students and whether associations were modified by psychological resilience. Methods: Data from 188 young adults (20.1±1.3 years of age; 27.6% female; 52.6% non-Hispanic White) from a northeastern university (Fall 2024-Spring 2025) were included in this analysis. Self-reported psychological distress was measured via the validated 4-item Perceived Stress Survey (PSS-4) and the 7-item Center for Epidemiologic Studies Depression Scale (CESD-7). Scores for both measures were derived by summing each of the items for a total stress and depression symptom score. Resilience was measured via the Brief Resilient Coping Scale. Life’s Essential 8 (LE8) related outcomes of blood pressure systolic (SBP) and diastolic blood pressure (DBP), body mass index (BMI), total cholesterol, and fasting glucose were measured by trained staff. Sleep quality was self-reported using the Pittsburgh Sleep Quality questionnaire, and current leisure physical activity (PA) was self-reported via the Global PA Questionnaire. Linear regression was used to examine the associations between psychological distress and the LE8-related outcomes, adjusting for age, gender identity, race, overall PA minutes, and year in school. Results: Average (±SD) PSS-4 and CESD-7 were 6.1±2.5 and 5.1±3.4, respectively. Mean and SD for cardiometabolic outcomes were: SBP (114.5±7.8 mmHg), DBP (70.4±7.9 mmHg), BMI (24.6±4.0 kg/m 2 ), total cholesterol (159.8±32.0 mg/dL), fasting glucose (90.5±11.9 mg/dL), leisure PA (520.7±350.8 MET-mins/week), and sleep quality (2.8±0.7) score. In fully adjusted models, stress -0.09 (95%CI, -0.13, -0.05) and depression symptoms -0.07, (-0.09, -0.04) were associated with lower quality sleep. Psychological distress was not associated with any other CVD risk factors, nor was psychological resilience a significant effect modifier of these associations (ps>0.05). Conclusions: Psychological distress may be particularly damaging for sleep quality among college-aged young adults. Given the emerging self-reliance during this transition to adulthood, promoting better sleep may assist in improving cardiovascular health among emerging adults.
Ajibewa et al. (2026) studied this question.