Reviewer ’s report  
 
Title: Age at mena rche and prevention of hypertension through lifestyle in young Chinese adult 
women: result from Project ELEFANT  
 
Version: 0 Date: 29 Aug 2018  
 
Reviewer: Philip Chilibeck  
 
Reviewer's report:  
 
This is a large population -based study in young Chinese women on the r elation between age at 
menarche and hypertension and how this is affected by a number of lifestyle factors. The 
manuscript is very clearly written and the results are clearly presented. I have a few comments; 
the most important which relate to providing gr eater detail on questionnaires used for collection 
of lifestyle data.  
 
Line 113: Please give the population of Tianjin along with the area.  
 
Line 141: Could you please give more information on how the psychological stress questionnaire 
is scored? Please give sufficient information so that a reader can reproduce your methods. If this 
is validated questionnaire, please provide a reference. If it was not a validated questionnaire, do 
you have any information on its validity? Likewise, do you have any information on its 
reproducibility/reliability?  
 
Lines 153 -154: Please also provide more detail on how imbalanced diet was scored. It sounds 
very subj ective. Was an objective score used?  
 
Is there a possibility of co -linearity (i.e. correlation between your independent variables) when 
entering BMI and imbalanced diet into the multiple regression? Does this impact the validity of 
your multiple regression ? 
 
Lines 181 -182: What is meant by "except for itself" here? Please clarify.  
 
Lines 245 -246: "Each lifestyle risk factor independently displayed a synergistic association with 
age at menarche in the risk of hypertension." Please explain what is meant by "s ynergistic" here.  
 
Table 1: To be consistent throughout the table, I suggest you don't include any decimal places.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any  stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial com peting interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare I have no competing interests  
 
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on my report to the authors and, if the manuscript is accepted for publication, my named report  
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