Review Reports - Prevalence, Risk Factors, and Multimorbidity Patterns in Climacteric Women with Hypertension

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

General Comment:

The manuscript addresses a relevant public health issue—the patterns and risk factors associated with multimorbidity among climacteric women with hypertension. The statistical analysis is solid, and the data are appropriately interpreted. However, several minor revisions are necessary to improve the clarity, language quality, and consistency of the text.

Specific Comments:

Abstract:

Line 15: Change “is still poorly understood” to “remains poorly understood” for better flow.

Line 20–21: “Age >70” should be revised as “age ≥70 years” for consistency with the rest of the paper.

Line 22: Replace “particularly in women aged ≥50” with “especially among women aged ≥50 years.”

Line 24: “Linked to” is vague; consider “associated with.”

Line 26: “Notably, 86% of hypertensive women had multimorbidity” is better placed earlier in the paragraph for impact.

Introduction:

Line 42: Typo in “medica-tions” → “medications.”

Lines 55–57: Consider restructuring for clarity: “Although BP levels increase with age in both sexes, the increase per decade is greater in women (8.1 mmHg) than in men (4.7 mmHg).”

Lines 59–61: Sentence could be rephrased for clarity: “Due to aging, hypoestrogenism, and lifestyle factors, climacteric women are increasingly presenting multiple chronic diseases.”

Methods:

Line 71: Consider specifying the year or period of data collection.

Line 88–89: Clarify BMI groups with hyphenation or semicolons for readability.

Lines 79–85: The definition of disease patterns is helpful, but some conditions (e.g., asthma and cancer) under "cardiometabolic" are not clearly justified there—consider further clarification or citing precedent.

Results:

Tables 2 and 3: Ensure formatting is consistent and clear. In Table 2, headings like "Unadjusted Analysis" and "Adjusted Analysis" should be clearly delineated.

Line 109: Consider rewriting “most frequent disease reported” as “most frequently reported disease.”

Line 114–116: The phrase “people aged 70 years or above” is vague—consider replacing “people” with “women.”

Discussion:

Line 143–144: “Women had a higher prevalence (96%) of arterial HT than men (79.5%)” seems unusually high—please clarify if this refers to hypertensive individuals only.

Line 170: “Exposure has also been demonstrated...” – revise for clarity. Suggestion: “Earlier natural or surgical menopause has also been linked to a higher risk of cardiovascular disease.”

Line 195: Typo in “microstructure change” → consider “microstructural changes.”

Lines 207–213: Limitations are appropriate. However, you might add that the cross-sectional design prevents causal inference.

Conclusions:

Line 215: “Face a significantly higher risk of developing multimorbidity” → “are at significantly higher risk of developing multimorbidity.”

Line 220: Consider softening “These results underscore the need…” to “These findings suggest the need for…”

Language & Style:

Improve consistency in terminology: use “hypertension” or “HT” uniformly.

Prefer “postmenopausal women” over “women in postmenopause.”

Avoid contractions (e.g., “can’t”) in scientific writing.

Some subject–verb agreement and article usage (e.g., “the pattern,” “a greater risk”) need polishing throughout.

Recommendation: Minor Revision

The manuscript is scientifically sound, relevant, and well-structured. However, it requires minor revisions regarding language, clarity, and consistency in formatting and terminology. Once these issues are addressed, the paper will be suitable for publication.

Author Response

General Comment:

Specific Comments:

Abstract:

Line 15: Change “is still poorly understood” to “remains poorly understood” for better flow.