Anxiety Severity as a Correlate of Perceived Cardiac Autonomic Symptoms in Female Medical Students Who Consume Energy Drinks and Tea: A Cross-Sectional Study from Sialkot, Pakistan
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Abstract
Background: Anxiety can produce palpitations, chest discomfort, dizziness, and breathlessness that overlap with symptoms attributed to caffeinated beverages, potentially complicating interpretation of stimulant-related symptom reports. Objective: To determine whether anxiety severity was independently associated with a high burden of self-reported cardiac autonomic symptoms among female medical students after accounting for energy drink consumption, tea intake, and other measured covariates. Methods: This analytical cross-sectional study included 274 female medical students from three medical colleges in Sialkot, Pakistan. Anxiety was assessed using the GAD-7. High cardiac autonomic symptom burden was defined using self-reported palpitations, chest discomfort, dizziness, and dyspnoea. Associations were examined using bivariate tests and multivariable logistic regression. The primary complete-case model included 175 participants, and a sensitivity analysis included 243. Results: At least mild anxiety was present in 187 participants (68.2%). Ninety-one (33.2%) met the high symptom-burden threshold. Mean GAD-7 scores were 11.26 ± 5.89 versus 7.30 ± 5.72 in participants with high versus lower symptom burden, respectively (mean difference 3.96, 95% CI 2.49–5.43; p<0.001). GAD-7 remained associated with high symptom burden in the primary model (aOR 1.18 per point, 95% CI 1.10–1.26; p<0.001) and sensitivity analysis (aOR 1.13, 95% CI 1.07–1.19; p<0.001). Conclusion: Anxiety severity was independently associated with self-reported cardiac autonomic symptom burden in this population, although the cross-sectional design does not establish causal direction.
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