Primary Submission Category: Gender
The Way to a Man’s Heart (Disease): Exploring Connections between Male Adherence with Gendered Behavior and Cardiovascular Disease Risk
Authors: Nathaniel Glasser Harold Pollack Jacob Jameson
Presenting Author: Nathaniel Glasser*
Objective: Cardiovascular disease (CVD) is a major source of modifiable morbidity and mortality. Rates vary by gender. We examine associations between male gendered behaviors (GB) in adolescence and early adulthood, and outcomes related to CVD risk conditions (hypertension, diabetes, and hyperlipidemia) in middle adulthood.
Methods: Prospective cohort study uses Wave I (1994-1995, participants aged 12-18), Wave IV (2008-2009, participants 23-32), and Wave V (2016-2018, participants 33-43) data from National Longitudinal Study of Adolescent to Adult Health. Associations between empirically-derived measure of male GB and hypertension, diabetes, and hyperlipidemia diagnoses, bio-measure data, and medication use modeled using multivariable regression, adjusting for participant and neighborhood covariates.
Results: among 1,476 males included, increased GB among males in Wave IV was associated with lower odds of diagnosis with all three conditions in Wave V: hypertension (𝛽 = -0.21, p < 0.01), diabetes (𝛽 = – 0.27, p < 0.01), and hyperlipidemia (𝛽 = – 0.16, p = 0.01). Lower odds of diagnoses were not explained by bio-measures, which did not signal significant associations between male GB and physiologic outcomes. However, male GB in Wave IV was significantly associated with lower marginal rates of Wave V medication use in men with poorly controlled blood pressure (dy/dx = – 0.04, p = 0.03) and self-reported diagnoses of hypertension (dy/dx = – 0.08, p = 0.03). Increased male GB in Wave I was also significantly associated with decreased Wave V anti-hypertensive use in men diagnosed with hypertension ( = – 0.10, p < 0.01).
Conclusions: Consistent with prior data that men are less likely to utilize preventive health care, we find that male GB are significantly associated with under-diagnosis and under-treatment of CVD-risk conditions.
.