Title: Prevalence and predictors of risk factors for cardiovascular diseases among women aged
15- 49 years across urban and rural India: Findings from a nationwide survey
Version: 1 Date: 15 Sep 2023
Reviewer:  Sabera Sultana
Reviewer's report:
The research article will add insights in the relevant field. The article is well written. However,
I have added some minor suggestions.
1.  In the abstract in the you should make two separate paragraphs for background and objectives.
You should convey the objectives of this study more clearly. For example, “the study aims to
estimate the national and regional level prevalence of biological and behavioral risk factors of
cardiovascular diseases and to identify their sociodemographic determinants”.
2. Please make two groups for predictors - biological and behavioral risk factors that you are
considering in this study along with the sociodemographic factors as exposure in the abstract
method section.
3. Line 124. “Modifiable risk factors for CVDs include, tobacco consumption, alcohol
consumption, obesity, insufficient physical activity, raised blood sugar, raised cholesterol
and diet.[4]” Please categorize the modifiable risk factors as – the behavioral risk factors
including…………….and the biological risk factors including…
4. Please rephrase the sentence “Even though, cardio-vascular diseases are one of the leading
causes of death and disability among women, globally as well as in India, the importance of
cardiovascular diseases in women’s health, medical research has generally involved more men
than women while considering cardiovascular health. [3]”. Intended meaning is not clear. Line
130-134.
5. Please mention about the relevant research gap in the last paragraph of the introduction section.
For example, in line number 135-137 you mentioned “Literature has shown evidence of varied
distribution of these risk factors across states, and rural and urban areas, with gradience in level
of epidemiological transition happening across different states.[1]” Please add if there was any
other study that addressed it partially or no study addressed this issue so far.
6. Line 137-140. Please rephrase and clearly communicate the objectives of this study.
7. Line 152. Please add what number of populations was represented by this sample size. Using
weight, you can do that.
8. Line 144. Instead of “Study design and participants” you can write “Study settings.”
”
9. Line 145. Please add “cross-sectional data/ survey”.
10. Please mention the percentage of missingness and how did you handle it.
11. Did you exclude pregnant women from the analysis? If so, please mention. If not, please
mention what percentage of women was pregnant and is it negligible enough to not make the
outcome biased?
12. Line 183-186. “Established risk factors for cardiovascular diseases including tobacco
consumption, alcohol consumption, overweight/obesity, waist-hip ratio, raised blood pressure,
raised blood sugar, and OCP consumption was taken as the dependent variable.” You should
rephrase it. For example “the behavioral risk factors including…………….and the biological
risk factors including……………..were used  as independent variables . Sociodemographic
factors including …………….. were used as dependent/exposure variables.”
13. Line 190. Why did you use international cut-off to define overweight or obese? Why not
ethnicity specific cut-off for Indian population (lower cut-off)?
14. Line 192-193. I think you are using the definition of stage 2 hypertension. So instead
of hypertension please write “stage 2 hypertension”. You used the definition “systolic blood
pressure > 140 mm of Hg or diastolic blood pressure > 90 mm of Hg”. Appropriate definition
is “systolic blood pressure > 140 mm of Hg or diastolic blood pressure > 90 mm of Hg”.”
15. Line 201. For oral contraceptive you considered past intake but for tobacco and alcohol you
did not consider past intake which was equally important.
16. In the conclusion you mentioned only about state wise disparity. But you measured and
found disparities on other sociodemographic factors as well. Your conclusions should be the
reflection of your objectives.