Child Marriage and Cardiovascular Risk: An Application of the Non-laboratory Framingham Risk Score.

Area of Science:

• Cardiovascular epidemiology
• Public health
• Societal impact on health

Background:

• Child marriage, defined as marriage before 18 years, represents a premature transition to adulthood with potential long-term health detriments.
• Adverse cardiovascular outcomes pose a significant global health burden, particularly in developing nations.

Purpose of the Study:

• To investigate the association between child marriage and increased risk of adverse cardiovascular outcomes in Indian adults.
• To assess the impact of early marriage on cardiovascular health using a nationally representative sample.

Main Methods:

• Utilized the non-laboratory-based Framingham algorithm to estimate predicted heart age (PHA) for 336,953 women and 49,617 men.
• Categorized individuals based on the difference between PHA and chronological age (CA) into low, equal, high, and very high PHA groups.
• Employed multivariable multinomial logistic regressions to determine relative risks associated with child marriage.

Main Results:

• Women married in childhood exhibited significantly higher adjusted risks of high (1.06 times) and very high (1.22 times) predicted heart age compared to adult-married women.
• No significant differential risks in predicted heart age were observed for men married as children versus adults.
• Findings remained robust across various socioeconomic strata, underscoring the consistent impact on women's cardiovascular health.

Conclusions:

• Child marriage is linked to an elevated risk of adverse cardiovascular outcomes in women, contributing to the growing body of evidence on long-term health consequences.
• These results offer crucial insights for public health initiatives focused on improving women's health and well-being by addressing the detrimental effects of child marriage.