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Brief Report

Impact of Gender on Cardiovascular Risk Factors in Post-COVID-19 University Students

by
Andrea Velásquez-Muñoz
1,* and
Raúl Acosta-Sepúlveda
2
1
Health Department, University of Los Lagos, Osorno 5170000, Chile
2
Department of Physical Activity Sciences, University of Los Lagos, Osorno 5170000, Chile
*
Author to whom correspondence should be addressed.
COVID 2025, 5(4), 49; https://doi.org/10.3390/covid5040049
Submission received: 23 January 2025 / Revised: 16 March 2025 / Accepted: 3 April 2025 / Published: 5 April 2025
(This article belongs to the Section COVID Public Health and Epidemiology)
Review Reports Versions Notes

Abstract

:
Cardiovascular diseases (CVD) are among the leading causes of morbidity and mortality worldwide. This descriptive-correlational cross-sectional study analyzed the relationship between lifestyle factors and cardiovascular parameters in 206 university students from the University of Los Lagos in the post-COVID-19 context, with a focus on gender differences. Indicators such as body mass index, waist circumference, blood pressure, blood glucose, sedentary behavior, tobacco and alcohol consumption, sleep quality, and self-reported stress were assessed. The results showed a higher prevalence of abdominal obesity and sedentary behavior in women, whereas men presented higher rates of hypertension and elevated blood glucose. While tobacco and alcohol consumption did not differ significantly between genders, both remain relevant risk factors in the university population. Sleep quality and stress were significantly correlated with various cardiovascular risk factors in both genders. These findings highlight the need for gender-specific interventions to address cardiovascular risk factors in university populations, emphasizing the promotion of physical activity among women and dietary strategies targeting sodium reduction among men. Future longitudinal research should assess whether these trends persist over time and explore effective intervention strategies.

1. Introduction

Cardiovascular diseases (CVD) represent one of the leading causes of morbidity and mortality worldwide, accounting for over 17 million deaths annually, at a figure that continues to rise [1]. Although cardiovascular diseases (CVD) primarily affect older adults, there is growing concern about the increasing prevalence of CVD risk factors among younger populations. This highlights the need for early prevention strategies targeting university students [2,3].
The COVID-19 pandemic has exacerbated this phenomenon, disrupting daily routines and generating a multifaceted impact on physical and mental health. During the lockdown, increased sedentary behavior, changes in dietary habits, and higher alcohol and tobacco consumption were reported. Additionally, pandemic-related stress and uncertainty negatively impacted sleep quality [4,5,6]. These factors have collectively contributed to an increase in cardiovascular risk, particularly among young populations.
A gender-specific focus on CVD is essential, as men and women exhibit notable differences in risk factors. Men tend to develop CVD at earlier ages due to greater biological predisposition and accumulated risk behaviors, while women’s risk increases significantly after menopause due to hormonal changes [7,8]. Although women initially present lower CVD incidence, they are generally less likely to engage in regular physical activity or acknowledge risky behaviors, such as excessive alcohol consumption—factors that deeply influence cardiovascular health [9,10].
The post-COVID-19 context has magnified these gender disparities. Lockdowns have increased sedentary behavior, altered dietary patterns, and affected mental health differently for men and women. The CorCOVID LATAM study showed that women reported higher rates of sedentary behavior, lower physical activity levels, and more psychological symptoms than men. Conversely, women were more likely to maintain healthier eating habits and had lower rates of tobacco and alcohol consumption [11]. These findings underscore the importance of tailoring gender-specific strategies to address the pandemic’s impact on cardiovascular health.
Universities play a critical role in promoting cardiovascular health through programs that foster healthier lifestyles among students. By addressing lifestyle changes, stress management, and dietary habits, universities can serve as platforms for targeted, sustainable interventions that align with the findings of this study. However, challenges such as academic stress, time constraints, and irregular eating habits unique to university life can hinder these efforts [12,13].
Understanding the post-COVID-19 impact on cardiovascular risk factors through a gendered lens allows for the development of effective preventive strategies. This approach leverages the unique opportunities that universities provide as environments to foster healthy lifestyles and mitigate long-term health risks.

1.1. Study Objective

This study aims to analyze the influence of gender on cardiovascular risk factors and lifestyle behaviors among university students at the University of Los Lagos in the post-COVID-19 period.

1.2. Hypothesis

Gender differences significantly influence cardiovascular risk factors and lifestyle behaviors among university students in the post-COVID-19 context.

2. Materials and Methods

2.1. Study Design

This descriptive-correlational cross-sectional study analyzed the relationship between lifestyle factors and cardiovascular parameters among university students, focusing on gender differences in the post-COVID-19 context. Data were collected between May and December 2023 under strict biosafety protocols.

2.2. Participants

The study included 206 undergraduate students from the University of Los Lagos, selected via non-probabilistic convenience sampling. Inclusion criteria were active enrollment, age of 18–25 years, and voluntary participation with informed consent. Exclusion criteria included chronic illnesses (e.g., diabetes, hypertension, cardiovascular diseases) and pregnancy.
Sample size was calculated using Cohen’s approach for medium effect sizes (d = 0.5) at α = 0.05 and power 1 − β = 0.80, requiring a minimum of 128 participants. A final sample of 206 enhanced statistical robustness.

2.3. Instruments and Measurements

2.3.1. Study Parameters:

For weight and height measurements, we used a calibrated scale with a stadiometer, with a precision of 0.1 kg and 0.2 cm (Detecto®, Webb City, MO, USA). For waist circumference, a flexible measuring tape, graduated in millimeters, was used. Measurements were taken at the end of a normal expiration, with the participant standing upright, arms relaxed at the sides, and the tape positioned at the midpoint between the lower edge of the last rib and the top of the iliac crest, along the mid-axillary line. Blood pressure was measured using the indirect auscultation method at the radial artery with a stethoscope and an aneroid sphygmomanometer (Lumiscope®, New York, NY, USA), following standard protocol. Two measurements were taken and averaged: the first after a 5 min rest period, and the second 5 min later. Fasting blood glucose was measured using an Accu-Chek® glucometer (Roche Diagnostics®, Basel, Switzerland).
BMI classification: according to WHO criteria, BMI was categorized as underweight (<18.5 kg/m2), normal weight (18.5–24.9 kg/m2), overweight (25.0–29.9 kg/m2), and obesity (≥30.0 kg/m2)
Waist circumference (WC): WHO protocols. Abdominal obesity thresholds: men (≥90 cm); women (≥80 cm).
Blood pressure (BP): calibrated sphygmomanometer. Normotension (<140/90 mmHg); hypertension (≥140/90 mmHg).
Capillary glucose: measured with a glucometer after 8 h fasting. Normoglycemia (<100 mg/dL); hyperglycemia (≥100 mg/dL).

2.3.2. Lifestyle Factors:

Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ) [14]. Alcohol consumption was measured using the Alcohol Use Disorders Identification Test (AUDIT), following WHO recommendations [15]. Tobacco use, drugs consumption, sleep quality, and stress levels were assessed using questions adapted from the II National Survey on Quality of Life and Health (ECV 2006, Chile) [16].
Physical activity classification: sedentary: <150 min/week; active: ≥150 min/week.
Alcohol use classification: men (≥8); women (≥6).
Tobacco use: smokers included daily/occasional users.
Drugs consumption classification: non-user: no reported drug use. Occasional user: drug use reported fewer than four times in the past six months. Frequent user: drug use reported four or more times in the past six months.
Sleep quality: self-rated as “good” (always/almost always) or “poor” (sometimes/rarely/never).
Perceived stress: frequency-based questions categorized participants as “stressed” (always/almost always) or “not stressed”.

2.4. Data Collection

Data were collected between May and December 2023 under strict biosafety protocols (e.g., mask use, equipment disinfection, physical distancing). Self-administered questionnaires were supervised, and anthropometric/cardiovascular measurements were conducted by trained personnel.

2.5. Statistical Analysis

Data were analyzed using SPSS version 23. Chi-square and Student’s t-tests assessed group differences, and Pearson correlation coefficients evaluated variable associations (significance: p < 0.05).

2.6. Ethical Considerations

Approved by the Ethics Committee of Valdivia Health Service (ord. N°087). Participants provided informed consent, and confidentiality was maintained in line with the Declaration of Helsinki.

3. Results

3.1. Evaluation of Cardiovascular Parameters by Gender

Significant differences were observed in cardiovascular parameters between men and women in the post-COVID-19 context (Table 1). Women exhibited a higher prevalence of abdominal obesity (47.9%) compared to men (28.1%, p = 0.004). Conversely, men showed a higher prevalence of hypertension (23.6%) compared to women (6.0%, p < 0.001). Although elevated blood glucose levels were more common in men (25.8%) than in women (15.4%), this difference was not statistically significant (p = 0.063).
Drug consumption demonstrated near-significant differences, with a higher prevalence among women (17.9%) compared to men (9.0%, p = 0.051).

3.2. Analysis of Lifestyle Factors by Gender

Lifestyle factors also varied by gender. Women reported higher levels of sedentary behavior (45.3%) compared to men (33.7% p = 0.093). Although this difference was not statistically significant, it is a notable finding for lifestyle evaluation.
No significant differences were found in tobacco use (32.6% in men vs. 38.5% in women, p = 0.411) or alcohol consumption (19.1% in men vs. 12.8% in women, p = 0.218). Regarding sleep quality, women reported a higher prevalence of poor sleep quality (79.5%) compared to men (69.7%, p = 0.106), though this difference was also not statistically significant.

3.3. Exploration of Associations Between Lifestyle Factors and Cardiovascular Parameters

All associations between lifestyle factors and cardiovascular risk parameters were analyzed. However, only statistically significant correlations (p < 0.05) are presented in Table 2:
  • Sedentary behavior among women showed a significant correlation with the prevalence of abdominal obesity (r = 0.45, p < 0.01).
  • Excessive sodium intake among men was significantly associated with hypertension (r = 0.38, p < 0.05).
  • Poor sleep quality was directly correlated with self-reported stress levels in both genders (r = 0.52, p < 0.001).
These findings underscore the interaction between cardiovascular risk factors and lifestyle behaviors in the post-COVID-19 context. They highlight the importance of designing gender-specific interventions to address these challenges effectively.

4. Discussion

This study provides valuable insights into cardiovascular risk factors and lifestyle habits among university students in the post-COVID-19 era. However, as our data were collected exclusively during this period, no direct comparison with pre-pandemic data was possible. While our results align with previous research on cardiovascular risk in university students, this study does not assess changes before and after COVID-19. Instead, it offers a cross-sectional perspective of the post-pandemic period. Future longitudinal studies are needed to evaluate the long-term impact of the pandemic on students’ cardiovascular health and lifestyle behaviors.
Comparing our results with previous studies helps contextualize the potential differences in lifestyle behaviors and cardiovascular risk factors after the pandemic. Pre-pandemic research, such as Morales et al. [17] in Chile, already indicated a strong association between sedentary behavior and cardiometabolic risk in university students. Our findings reinforce this pattern, showing a higher prevalence of sedentarism and abdominal obesity, particularly among women. However, some pre-pandemic studies, such as Hernández-Gallardo et al. [18] in Ecuador, suggested that abdominal obesity was predominantly a male issue, indicating that differences in post-pandemic lifestyle behaviors may have contributed to a greater impact on female students. Further research comparing pre- and post-pandemic data is necessary to confirm this.
Similarly, research by Real Delor [19] in Paraguay reported a 54.1% prevalence of sedentary behavior in university students, aligning with our findings. Given that sedentary behavior was already prevalent in university students before the pandemic, further research is needed to assess whether COVID-19-related restrictions intensified this pattern. In contrast, studies like Duin-Balza et al. [20] in Venezuela identified high rates of alcohol and tobacco consumption before the pandemic, similar to our study’s post-pandemic findings. These findings suggest that these behaviors were already established among university students prior to the pandemic, rather than being a direct consequence of it.
Women were more likely than men to present with abdominal obesity and sedentary behavior, emphasizing the importance of gender-specific interventions. This aligns with previous research indicating greater vulnerability in women due to lower physical activity levels and challenges in balancing studies and self-care [4,11,21]. Gender-specific interventions should be prioritized, as studies have consistently shown that women face greater barriers to engaging in regular physical activity, such as safety concerns, lack of time, and sociocultural expectations.
For men, the higher prevalence of hypertension and elevated glycemia appears to be linked to unhealthy dietary habits, such as excessive sodium intake. While confinement-related restrictions likely impacted access to balanced food options, further studies are needed to assess whether these patterns persisted post-pandemic. Additionally, restrictions on movement likely had adverse effects on diet and exercise [22,23,24]. These findings emphasize the necessity of educational programs promoting low-sodium diets and effective hypertension management strategies from an early age.
Alcohol and tobacco consumption did not show significant gender differences in this study; however, both remain concerning cardiovascular risk factors, particularly in the post-COVID-19 context. Overall, 69.5% of men and 68.2% of women reported consuming alcohol at least once in the past month, while hazardous or harmful alcohol consumption, as measured by an AUDIT score of ≥6 for women and ≥8 for men, was observed in a smaller proportion of participants. Previous research has indicated that women tend to underestimate their intake, whereas men are more likely to engage in binge drinking episodes [11,25]. Previous studies have reported increased alcohol consumption among men, individuals with higher education, and urban residents. While some research suggests that heavy drinking rose from 20.9% to 25.7% during the pandemic, our findings do not provide direct evidence of a sustained increase in the post-pandemic period [26,27].
Regarding tobacco use, consumption rates of 18.4% in women and 20.1% in men highlight the need for preventive strategies. International studies have reported that up to 30% of smokers increased their cigarette consumption during the pandemic, with heavy smoking rising from 5.8% to 7.9%. These changes not only impact cardiovascular health, but also have detrimental effects on the immune system, emphasizing the importance of designing effective interventions to address alcohol and tobacco use in this population [4,28].
The correlation between poor sleep quality, stress, and cardiovascular factors highlights the interplay between physical and mental health in university students, emphasizing the need for comprehensive interventions [27,28]. Stress, understood as a dynamic response of the body to perceived excessive demands, has been identified as a critical factor in university students. High levels of academic stress have been associated with depression, anxiety, self-harm, lower self-esteem, and poor academic performance—issues that persisted even after the pandemic in global contexts such as China, Ecuador, and Mexico [4,5,6,11,29,30,31]. Sleep quality, widely impacted by pandemic-induced stress, is also associated with increased cardiovascular risk and other chronic conditions, underscoring the importance of interventions to mitigate these factors in young populations.
Universities play a pivotal role in mitigating these risk factors. They must develop health promotion programs tailored to the current context, including workshops on stress management, campaigns to reduce alcohol and tobacco use, and the creation of spaces that encourage physical activity. Additionally, interventions should be designed with gender differences in mind, as strategies effective for one group may not be as effective for the other. For example, women should focus on increasing physical activity and improving sleep quality, while men should prioritize dietary changes and hypertension control [12,13,32,33].
From a public health perspective, the findings highlight the importance of developing sustainable and gender-sensitive interventions targeted at young adults, a demographic often overlooked in cardiovascular prevention efforts. Addressing these issues within universities would not only have a direct impact on the university community but could also serve as a model for broader community-based approaches, contributing to the achievement of Sustainable Development Goal (SDG) 3, which aims to ensure healthy lives and promote well-being for all ages.

5. Conclusions

Our findings highlight the urgent need for tailored prevention and intervention strategies addressing cardiovascular risk factors in university students, especially in the post-pandemic context. While the pandemic disrupted health habits, it also underscored the importance of sustainable health promotion initiatives within educational institutions.
Women exhibited higher levels of sedentary behavior and abdominal obesity, reinforcing the need for gender-sensitive interventions that promote physical activity and address sociocultural barriers. Universities should implement safe and accessible exercise spaces alongside workshops focused on self-care and healthy habits to support female students in adopting an active lifestyle.
Conversely, the higher prevalence of hypertension and elevated glucose levels among men suggests the need for dietary interventions, particularly sodium reduction and nutritional education. Universities can integrate dietary counseling and awareness programs into their student health services to encourage healthier eating habits.
Beyond physical health, the interconnection between cardiovascular risk factors, stress, and mental health highlights the necessity of comprehensive wellness programs. Institutions should develop multidisciplinary approaches that include stress management initiatives, physical activity promotion, and mental health support, ensuring students receive personalized guidance to maintain long-term cardiovascular health.
Universities have a unique opportunity to act as catalysts for health promotion. Establishing wellness centers that integrate preventive care, education, and psychological support could serve as a sustainable model for improving student health. Future research should focus on evaluating the effectiveness of these interventions and monitoring long-term health trends in the university population.

Author Contributions

Conceptualization, A.V.-M. and R.A.-S.; methodology, A.V.-M.; software, A.V.-M.; validation, A.V.-M. and R.A.-S.; formal analysis, A.V.-M.; investigation, A.V.-M.; resources, A.V.-M.; data curation, A.V.-M.; writing—original draft preparation, A.V.-M.; writing—review and editing, A.V.-M. and R.A.-S.; visualization, A.V.-M.; supervision, A.V.-M.; project administration, A.V.-M. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of the Valdivia Health Service (protocol code 087).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

The data presented in this study are available on request from the corresponding author. The data are not publicly available due to ethical restrictions.

Acknowledgments

The authors express their gratitude to the academics and students who supported this study and to all the students who participated in it. We also extend our sincere thanks to the Vice-Rectorate for Research of the University of Los Lagos for its valuable support.

Conflicts of Interest

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Abbreviations

The following abbreviations are used in this manuscript:
CVDCardiovascular diseases
BMIBody mass index
WCWaist circumference
BPBlood pressure
IPAQInternational Physical Activity Questionnaire
AUDITAlcohol Use Disorders Identification Test

References

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Table 1. Prevalence of cardiovascular parameters and gender in university students.
Table 1. Prevalence of cardiovascular parameters and gender in university students.
VariableMen (%)Women (%)Chi-Square (χ2)p-Value
Sedentary Lifestyle33.7%45.3%2.8230.093
Smoking32.6%38.5%0.6760.411
Alcohol Consumption19.1%12.8%1.5200.218
Sleep Quality69.7%79.5%2.6190.106
Stress19.5%20.2%0.0140.905
Body Mass Index13.5%18.8%1.0380.308
Abdominal Obesity28.1%47.9%8.2830.004
Blood Pressure (BP)23.6%6.0%13.351<0.001
Blood Glucose Level25.8%15.4%3.4680.063
Drug Consumption9.0%17.9%5.9590.051
Note: This table summarizes the prevalence of cardiovascular parameters and lifestyle factors among university students, disaggregated by gender. Chi-square (χ2) values and p-values indicate the statistical significance of differences between men and women. The consumption of alcohol (hazardous or harmful) was defined as an AUDIT score of ≥6 for women and ≥8 for men.
Table 2. Associations between lifestyle factors and cardiovascular parameters.
Table 2. Associations between lifestyle factors and cardiovascular parameters.
Lifestyle FactorGenderCardiovascular ParameterCorrelation Coefficient (r)p-Value
Sedentary behaviorWomenAbdominal obesity0.45<0.01
Excessive sodium intakeMenHypertension0.38<0.00
Poor sleep qualityBothSelf-reported stress levels0.52<0.001
Note: Although not statistically significant, drug consumption showed a correlation with cardiovascular parameters, suggesting potential relevance for further longitudinal analyses.
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Velásquez-Muñoz, A.; Acosta-Sepúlveda, R. Impact of Gender on Cardiovascular Risk Factors in Post-COVID-19 University Students. COVID 2025, 5, 49. https://doi.org/10.3390/covid5040049

AMA Style

Velásquez-Muñoz A, Acosta-Sepúlveda R. Impact of Gender on Cardiovascular Risk Factors in Post-COVID-19 University Students. COVID. 2025; 5(4):49. https://doi.org/10.3390/covid5040049

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Velásquez-Muñoz, Andrea, and Raúl Acosta-Sepúlveda. 2025. "Impact of Gender on Cardiovascular Risk Factors in Post-COVID-19 University Students" COVID 5, no. 4: 49. https://doi.org/10.3390/covid5040049

APA Style

Velásquez-Muñoz, A., & Acosta-Sepúlveda, R. (2025). Impact of Gender on Cardiovascular Risk Factors in Post-COVID-19 University Students. COVID, 5(4), 49. https://doi.org/10.3390/covid5040049

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