Investigating Serum Cortisol Dynamics and Cardiovascular Impacts Amid University Exam Stress: A Pre-Post Cohort Study

Our objective was to investigate the perceived stress levels among pharmacy students enrolled at the University of Duhok both prior to and following examination periods, with a concurrent assessment of potential cardiovascular effects.

The study included 49 participants from the College of Pharmacy at the University of Duhok and utilized a pre-post cohort design. High-stress pre-examination assessments were scheduled at 8:30 AM on the day of the examination, and low-stress post-examination assessments were also conducted at 8:30 AM over a two-week period without academic examinations.

The pre-exam serum cortisol level was significantly higher compared to the post-exam period (16.66 vs. 14.04 μg/dL; p = 0.013). Elevated levels of non-high-density lipoprotein (HDL) cholesterol, and cholesterol/HDL ratio were recorded during high-stress periods. Remarkably, social media emerged as the sole significant predictor (p = 0.038) with a negative impact on serum cortisol levels during the pre-exam phase. Additionally, we observed that females had higher stress levels during both periods, as indicated by the regression model.

This investigation revealed a significant elevation in serum cortisol levels during the pre-examination phase, likely attributable to the stress induced by impending examinations.