Atherogenic dyslipidemia and associated risk factors among hypertensive patients of five health facilities in Northeast Ethiopia

Ousman Mohammed; Ermiyas Alemayehu; Endris Ebrahim; Mesfin Fiseha; Alemu Gedefie; Abdurrahman Ali; Hussen Ebrahim; Mihret Tilahun

doi:10.1371/journal.pone.0277185

Peer Review History

Original SubmissionJune 25, 2022
9 Aug 2022 Decision Letter - Paolo Magni, Editor PONE-D-22-18116Atherogenic dyslipidemia and associated risk factors among hypertensive patients of five health facilities in Northeast EthiopiaPLOS ONE Dear Dr. Ousman Mohammed, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please especially pay attention to comments by Reviewer 2. They need to be fully addressed. Please submit your revised manuscript by Sep 23 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Paolo Magni Academic Editor PLOS ONE Journal Requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. Thank you for stating the following in your Competing Interests section: "The authors declare that they have no potential competing interests." Please complete your Competing Interests on the online submission form to state any Competing Interests. If you have no competing interests, please state ""The authors have declared that no competing interests exist."", as detailed online in our guide for authors at http://journals.plos.org/plosone/s/submit-now This information should be included in your cover letter; we will change the online submission form on your behalf. 3. We note that you have indicated that data from this study are available upon request. 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To do this, go to ‘Update my Information’ (in the upper left-hand corner of the main menu), and click on the Fetch/Validate link next to the ORCID field. This will take you to the ORCID site and allow you to create a new iD or authenticate a pre-existing iD in Editorial Manager. Please see the following video for instructions on linking an ORCID iD to your Editorial Manager account: https://www.youtube.com/watch?v=_xcclfuvtxQ 5. Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Additional Editor Comments: The paper requires some polishing of the language and some details still need to be improved according to Reviewer 2. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: No ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: A well written report of an interesting topic in Ethiopia. The manuscript is technically sound and all the data support the conclusions. The statistical analysis has been performed appropriately and rigorously. Well done. Reviewer #2: This manuscript answers a relevant research question and uses the correct methodology to do so. While it should be clear that associations found through the logistic regression are exploratory in nature, with the study not powered to consider this amount of predictors, the level of proof is generally high. The manuscript is of decent quality and almost ready for publication as far as I am concerned, although some improvements and clean-up remains to be done. Please find my suggestions for updates below. Major comments (1) The primary objective and most important outcome of this study is the percentage of hypertensive people with dyslipidemia. The sample size was calculated to estimate this with a specific precision. Yet, no confidence intervals are presented around the point estimates of the actual percentage of hypertensive people with dyslipidemia. Such CIs are useful as they indeed show how precise the estimates for prevalence of the different dyslipidemia markers are. (2) Wording referring to the population (results, discussion): Sometimes “participants” is used, other times “people” or identifiers like “women”. None of these are technically correct. The population here is “people with hypertension in Northeast Ethiopia”, which is different from the sample (a subset of such people) or from “people” in general. While it doesn’t need to be repeated constantly, some attention should be given throughout the manuscript to the fact that this analysis is representative for the proper population: people with hypertension in Northeast Ethiopia. This is correctly done in the abstract and conclusion. (3) Material & Methods: sometimes too much details are given and information tends to get needlessly repeated Examples: definition of BMI (repeated twice, and common knowledge so not needed), multiple repeats on how height measurements are taken, paragraph on quality control can probably be shortened, … (4) Table 5: please format the table better, it is hard to read like this. Table 5 and Table 6: please doublecheck all numbers carefully. Some results, while possible, are a bit strange. It is unclear to me how confidence intervals for logistic regression are calculated in SPSS, these results do not match what other statistical software could give. A few examples: 2.02(1.62-3.70) (maybe the lower bound is 1.26?); 1.33(1.08-1.40) , 2.86(1.65-3.14) (does not make sense that the estimate is closer to the upper bound in these cases). Since it’s very easy to introduce typos when copying the results from the statistical package to the manuscript, authors should carefully doublecheck every number. (5) Conclusion: “were significant determinants of dyslipidemia” Alas, you did it perfect during the whole paper, even correctly explicitly mentioning that a cross-sectional study cannot address causal links. Since no causality can be concluded, you should not state that these are “determinants” of dyslipidemia. Instead using “predictors” or “significantly associated” are both correct options. (6) I did not find a data sharing statement in the manuscript. Instead, when talking about data sharing, you replied "No - some restrictions will apply" and data available "On request". I understand that this is not a sufficiently detailed answer in light of the PLOS Data Policy. Please provide clear instructions on how a sufficiently anonymised version of the data can be obtained. Minor comments: (7) Abstract and page 7 (Data analysis): “Statistical significance was declared at p ≤0.05.” Please change to p < 0.05 (shouldn’t make a difference in results or interpretation). (8) Page 5: (Study Population and legibility Criteria) “All volunteer hypertensive patients (…) were eligible. However (…)” Please rewrite. The part following “however” makes it clear that not all patients were eligible. (9) Page 5: (Data collection and quality control) “Well-trained two data collectors” Rewrite to “Two well-trained data collectors” (10) Table 1: HDL-c <40 mg/dL vs. occupation: p-value is missing for this specific comparison (11) Page 11, bottom: “the habit of not eating fruits and vegetables were substantially linked with elevated TC levels but not with elevated TG levels (Table 5).” Replace substantially by significantly. Substantial would be linked to effect size, while this statement should only refer only to statistical significance. (12) Page 14: “(AOR: 1.49, 95%CI: 127-1.91)”: add decimal sign in 1.27 “and 2.0 (AOR: 1.90, 95%CI: 1.51-2.52)”: change 2.0 by 1.9 ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0277185.r001
Revision 1
16 Aug 2022 Author Response Dear editors and reviewers, I greatly acknowledge your comments which are actually very crucial for the quality of the paper as well as for my future improvements. As per your comments, all things are corrected and the corrected parts were alighted with green. Major comments Reviewer point #1): The primary objective and most important outcome of this study is the percentage of hypertensive people with dyslipidemia. The sample size was calculated to estimate this with a specific precision. Yet, no confidence intervals are presented around the point estimates of the actual percentage of hypertensive people with dyslipidemia. Such CIs are useful as they indeed show how precise the estimates for prevalence of the different dyslipidemia markers are. Author response: Yes, we agreed with the reviewers, a 95% CI was calculated and indicated in the result part. Here is the calculated CI (93.2%; 95%CI: 90.6-95.6) Reviewer point #2): Wording referring to the population (results, discussion): Sometimes “participants” is used, other times “people” or identifiers like “women”. None of these are technically correct. The population here is “people with hypertension in Northeast Ethiopia”, which is different from the sample (a subset of such people) or from “people”ingeneral. While it doesn’t need to be repeated constantly, some attention should be given throughout the manuscript to the fact that this analysis is representative for the proper population: people with hypertension in Northeast Ethiopia. This is correctly done in the abstract and conclusion. Author response: Of course, this study was inferred to the hypertensive individuals so, as per the reviewer's comment we tried to replace some identifiers like “women, people, and participants with more appropriate descriptions like hypertensive individuals or people with hypertension. Reviewer point #3): Material & Methods: sometimes too much details are given and information tends to get needlessly repeated Examples: definition of BMI (repeated twice, and common knowledge so not needed), multiple repeats on how height measurements are taken, paragraph on quality control can probably be shortened, Author response: Here we accepted the reviewer's comment and it was due to clerical errors. Now we avoid repetitive descriptions and unnecessary details and it was shown in the manuscript. Reviewer point #4): Table 5: please format the table better, it is hard to read like this. Table 5 and Table 6: please doublecheck all numbers carefully. Some results, while possible, are a bit strange. It is unclear to me how confidence intervals for logistic regression are calculated in SPSS, these results do not match what other statistical software could give. A few examples: 2.02(1.62-3.70) (maybe the lower bound is 1.26?); 1.33(1.08-1.40), 2.86(1.65-3.14) (does not make sense that the estimate is closer to the upper bound in these cases). Author response: Based on the reviewer’s suggestion we tried to check all the numbers carefully. Since it was an error while copying numbers and now it was solved and corrected. Reviewer point #5): Conclusion: “were significant determinants of dyslipidemia” Alas, you did it perfect during the whole paper, even correctly explicitly mentioning that a cross-sectional study cannot address causal links. Since no causality can be concluded, you should not state that these are “determinants” of dyslipidemia. Instead using “predictors” or “significantly associated” are both correct options. Author response: Yes we accept the reviewer's comment and we corrected it following the reviewer's suggestion. Reviewer point #6): I did not find a data sharing statement in the manuscript. Instead, when talking about data sharing, you replied "No - some restrictions will apply" and data available "On request". I understand that this is not a sufficiently detailed answer in light of the PLOS Data Policy. Please provide clear instructions on how a sufficiently anonymised version of the data can be obtained. Author response: It was an error while submitting the manuscript online and I can assure you that all relevant data are included in the paper. Minor comments: Reviewer point #7): Abstract and page 7 (Data analysis): “Statistical significance was declared at p ≤0.05.” Please change to p < 0.05 (shouldn’t make a difference in results or interpretation). Author response: Yes we have corrected p ≤0.05 was changed to p < 0.05 Reviewer point #8): Page 5: (Study Population and legibility Criteria) “All volunteer hypertensive patients (…) were eligible. However (…)” Please rewrite. The part following “however” makes it clear that not all patients were eligible. Author response: Some physiological and pathological factors that could alter serum lipid profiles, such as pregnancy, taking lipid-altering drugs, and antihyperlipidemic medications, were excluded because the study was designed to assess dyslipidemia. Reviewer point #9): Page 5: (Data collection and quality control) “Well-trained two data collectors” Rewrite to “Two well-trained data collectors” Author response: Yes we have to rewrite it as per the reviewer's comment. Reviewer point #10): Table 1: HDL-c <40 mg/dL vs. occupation: p-value is missing for this specific comparison Author response: The missing p-value was putt as 0.21 in the space provided. Reviewer point #11): Page 11, bottom: “the habit of not eating fruits and vegetables were substantially linked with elevated TC levels but not with elevated TG levels (Table 5).” Replace substantially by significantly. Substantial would be linked to effect size, while this statement should only refer only to statistical significance. Author response: Here we have replaced the word ‘substantially’ with significantly and you can see it in the manuscript. Reviewer point #12): Page 14: “(AOR: 1.49, 95%CI: 127-1.91)”: add decimal sign in 1.27 “and 2.0 (AOR: 1.90, 95%CI: 1.51-2.52)”: change 2.0 by 1.9 Author response: Yes it was corrected. Attachments Attachment Submitted filename: Response to reviewers.docx https://doi.org/10.1371/journal.pone.0277185.r002
21 Sep 2022 Decision Letter - Paolo Magni, Editor PONE-D-22-18116R1Atherogenic dyslipidemia and associated risk factors among hypertensive patients of five health facilities in Northeast EthiopiaPLOS ONE Dear Dr. Ousman Mohammed, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please address the reviewers'comments. Please submit your revised manuscript by October . If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Paolo Magni Academic Editor PLOS ONE Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Additional Editor Comments (if provided): Some aspects need some improvement. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed Reviewer #2: (No Response) ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: No ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Well done on your study. The introduction is well written, the methods are adequately described and the discussion/conclusion is supported by the results. Maybe it could be worthy to amend the design of the tables to increase readability. Reviewer #2: Please review the data availability policy. https://journals.plos.org/plosone/s/data-availability It is still unclear to me whether the data source, or an anonymised version thereof will be made freely available. The statement "Yes - all data are fully available without restriction" and the reply to the comment that "all relevant data are included in the paper" are contradictory. "All data" would at minimum be a dataset with a single line per patient that was included in the study and a single column for each variable that was reported in this manuscript. No instructions on how or where to obtain such dataset are provided. ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0277185.r003
Revision 2
22 Sep 2022 Author Response Dear Editors and Reviewers, As per your comments, everything was revised and fixed in the last submission. However, aside from the Data Availability Statement concern expressed by Reviewer 2, I couldn't find any particular concerns that still needed to be fixed and submitted with tracked modifications. I stated that there are some restrictions in my initial proposal. Naturally, it was a mistake that was done by the correspondence author alone, who neglected to pay attention during the online submission process. However, I had highlighted it in my prior responses to reviewers when I stated, "All the essential data are within the manuscript." Therefore, I have also included the Data Availability Statement by saying ‘All the relevant data are within the manuscript’ in the manuscript. Thank you very much for your consideration. Your Sincerely, Attachments Attachment Submitted filename: Response to editors and reviewers.docx https://doi.org/10.1371/journal.pone.0277185.r004
17 Oct 2022 Decision Letter - Paolo Magni, Editor PONE-D-22-18116R2Atherogenic dyslipidemia and associated risk factors among hypertensive patients of five health facilities in Northeast EthiopiaPLOS ONE Dear Dr. Mohammed, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Specifically, please address the comment by the reviewer: "The data statement refers to all data being contained in the manuscript, this is not correct.". Please submit your revised manuscript by October 26, 2022. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Paolo Magni Academic Editor PLOS ONE Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Additional Editor Comments: The Authors just need to address the comment by the reviewer (The data statement refers to all data being contained in the manuscript, this is not correct.). [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #2: (No Response) ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #2: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #2: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #2: No ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #2: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #2: Please refer to my previous review. The data statement refers to all data being contained in the manuscript, this is not correct. Please discuss with the editor how data will be made available and/or which restrictions will apply. ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #2: No ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0277185.r005
Revision 3
17 Oct 2022 Author Response Dear Editors and Reviewers, Reviewer point: Have the authors made all data underlying the findings in their manuscript fully available? Author response: Pardon me for the inconvenience. As per your comments, everything was revised and fixed in the last submission. However, I stated that there are some restrictions in my initial submission; naturally, it was a mistake that was done by the correspondence author alone, who neglected to pay attention during the online submission process. Now I assure you again there is no restriction regarding data availability at all. Therefore, I have also included the Data Availability Statement by saying; we will provide repository information for our data at acceptance as Supporting Information files. And I highlighted it with yellowish. Editor point: Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Author response: I have already checked all the references, and it is complete and correct. Thank you very much for your consideration. Kind regards, Ousman Attachments Attachment Submitted filename: Response to editors and reviewers.docx https://doi.org/10.1371/journal.pone.0277185.r006
24 Oct 2022 Decision Letter - Paolo Magni, Editor Atherogenic dyslipidemia and associated risk factors among hypertensive patients of five health facilities in Northeast Ethiopia PONE-D-22-18116R3 Dear Dr. Mohammed, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Paolo Magni Academic Editor PLOS ONE Additional Editor Comments (optional): All comments have been addressed. Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #2: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #2: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #2: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #2: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #2: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #2: (No Response) ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #2: No ******** https://doi.org/10.1371/journal.pone.0277185.r007
Formally Accepted
11 Nov 2022 Acceptance Letter - Paolo Magni, Editor PONE-D-22-18116R3 Atherogenic dyslipidemia and associated risk factors among hypertensive patients of five health facilities in Northeast Ethiopia Dear Dr. Mohammed: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Prof. Paolo Magni Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0277185.r008

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