At least half of all adults in the U.S. have at least one form of cardiovascular disease, a group of conditions that affects your heart and blood vessels. It includes common medical issues such as hypertension, high cholesterol and irregular heartbeat. People of all ages, sexes, ethnicities and socioeconomic levels are affected.

The good news is that many heart diseases can be prevented or modified with medical interventions or lifestyle changes. But if you're a “macho” guy who aligns strongly with stereotypical male roles, a new study shows you'll be less likely to address your cardiovascular condition and get treatment.

“…[P]ressures to convey identity – whether it's rooted in gender, race, sexuality or something else – impact health behaviors.”

Researchers at the University of Chicago found that boys and men who identify with machismo behaviors are less likely to deal with their cardiovascular risk factors. This isn't entirely groundbreaking news. There's already existing research showing that if you're a guy who aligns strongly with male gender identity, your behavior will be linked to detrimental health-related behaviors such as substance use and rejection of medical therapies and recommendations, especially when it comes to mental health and primary care.

The new study examines the issue specifically in terms of heart health using data that were collected over more than two decades. “In this new paper, we used innovative measurement techniques to look at the construction of male gender and how it's associated with cardiovascular disease prevention,” Nathaniel Glasser, a general internist and pediatrician at UChicago Medicine and lead author on the paper, said in a press release.

To do this, Glasser and his colleagues analyzed data from Add Health, a national, longitudinal study that collected health measurements and survey answers from more than 12,300 people at multiple points over the course of 24 years — from 1994 to 2018.

They rated male gender expression by identifying a subset of survey questions that were answered most differently by self-identified male versus female participants. Then they measured how closely the male participants' answers to those questions matched with their same-gendered peers. They focused on self-reported behaviors, preferences and beliefs that encouraged “self-reliance, emotional control, and strength while discouraging help-seeking, vulnerability, or weakness.”

Men who showed more stereotypical gender expression were significantly less likely to report that a healthcare professional had ever told them about certain cardiovascular disease risk conditions. Even when these men did report having previously received a diagnosis, they were still less likely to report that they were taking medication to treat these conditions.

Glasser sees the study as indicating a wider issue than just a gender-related one. “We're seeing how pressures to convey identity — whether it's rooted in gender, race, sexuality or something else — impact health behaviors,” Glasser said. “Fitting in and achieving belonging is a complicated task, and we feel strongly that increased societal sympathy, empathy and patience for others undertaking that task would be good for people's health.”

The study is published in JAMA Network Open.