Stress, Health Behaviors, and Blood Pressure in College Students

College students face multiple stressors, yet few studies have simultaneously examined associations between blood pressure, health behaviors (diet, physical activity, weight management, alcohol, tobacco, sleep), depressive symptoms, and perceived stress after multivariable adjustment. This cross-sectional study investigated these associations in a diverse university sample.

A convenience sample of 520 students from a public university in Southern California completed validated self-report measures, including the Perceived Stress Scale (PSS-10), Patient Health Questionnaire (PHQ-9), and Hypertension Self-Care Activity Level Effects (H-SCALE), and underwent objective blood pressure, height, and weight measurements. Approximately 750 students were approached; 520 participated (69.3% participation rate). Multiple linear regression (α = 0.05) was used to identify predictors of stress while controlling for demographics, health behaviors, and clinical variables.

Participants (mean age 22.99 ± 4.78 years; 64.8% female; 53.5% Hispanic/Latino) had a mean stress score of 18.80 ± 6.19. In the multivariable model (F[21,225] = 7.426, p < 0.001, R ² = 0.409; n = 247 complete cases), higher stress was significantly associated with higher diastolic blood pressure (β = 0.153, p = 0.030) and depressive symptoms (β = 0.509, p < 0.001), whereas adherence to a healthy diet (β = -0.118, p = 0.040) and weight management behaviors (β = -0.156, p = 0.008) was associated with lower stress. Systolic blood pressure, sleep duration, physical activity, smoking, and alcohol use were not significant predictors.

In this university sample, elevated depressive symptoms and diastolic blood pressure were associated with higher perceived stress, whereas healthy dietary practices and weight management behaviors were associated with lower stress. These associations suggest potential targets for campus wellness programs; however, longitudinal studies are needed to establish temporal relationships and intervention efficacy.