Dear Dr. Akter,

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 submit your revised manuscript by Jul 04 2025 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.

• 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,

Md. Feroz Kabir, BPT, MPT, MPH, BPED, MPED

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. We note that your Data Availability Statement is currently as follows: [All relevant data are within the manuscript and its Supporting Information files]

Please confirm at this time whether or not your submission contains all raw data required to replicate the results of your study. Authors must share the “minimal data set” for their submission. PLOS defines the minimal data set to consist of the data required to replicate all study findings reported in the article, as well as related metadata and methods (https://journals.plos.org/plosone/s/data-availability#loc-minimal-data-set-definition).

For example, authors should submit the following data:

- The values behind the means, standard deviations and other measures reported;

- The values used to build graphs;

- The points extracted from images for analysis.

Authors do not need to submit their entire data set if only a portion of the data was used in the reported study.

If your submission does not contain these data, please either upload them as Supporting Information files or deposit them to a stable, public repository and provide us with the relevant URLs, DOIs, or accession numbers. For a list of recommended repositories, please see https://journals.plos.org/plosone/s/recommended-repositories.

If there are ethical or legal restrictions on sharing a de-identified data set, please explain them in detail (e.g., data contain potentially sensitive information, data are owned by a third-party organization, etc.) and who has imposed them (e.g., an ethics committee). Please also provide contact information for a data access committee, ethics committee, or other institutional body to which data requests may be sent. If data are owned by a third party, please indicate how others may request data access.

Additional Editor Comments:

Please submit the revised manuscript within the next 15 days. Please carefully revise the manuscript according to the comments of the reviewers.

[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?

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

Reviewer #4: No

**********

2. Has the statistical analysis been performed appropriately and rigorously? -->?>

Reviewer #1: No

Reviewer #2: No

Reviewer #3: Yes

Reviewer #4: No

**********

3. Have the authors made all data underlying the findings in their manuscript fully available??>

The PLOS Data policy

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

Reviewer #4: Yes

**********

4. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

Reviewer #4: Yes

**********

Reviewer #1: The manuscript focuses on a health issue that is highly relevant for research and practical purposes.

1. Although the manuscript is clear and for the most part coherent, the novelty aspect is quite weak. Thus, I find it hard to recommend it for publication in its current form. It seems that the gap is related to the the lack of research to "provide culturally relevant insights to guide effective healthcare interventions and improve the well-being of individuals living with hypertension.". The authors did not make it clear how the existing literature is lacking in this matter. Additionally, how does measuring QOL would fill this gap? What other alternatives are there to solve this problem? Is compiling QOL data the most effective way to solve the problems? I highly doubt the assertion that "Without this data, it’s hard to develop effective and culturally appropriate strategies to support and improve the well being of hypertensive patients". There are already a strong body of knowledge to be used. If it is indeed culturally inappropriate for Bangladeshi context, then the authors have to explain so.

A stronger and clearer argument need to be written to highlight the novelty of this study.

2. From a research literature perspective, it is not clear why hypertensive patients were chosen as the focus of the study. How are the patients different enough compared to other patients? Why can't the authors simply use existing studies on QOL of patients with various illnesses to "develop effective and culturally appropriate strategies".

3. Conclusion section: "As predictor, poor QOL in all domains were found significant among the older, diabetic patients who had history of COVID-19, and poor monthly family income." I have 2 concerns about this conclusion:

a. If the authors want to address cultural nuances, how does these significant predictors relate to cultural uniqueness of Bangladesh? In other words, what culture specific findings are there?

b. How will these findings help in designing effective strategies? Increase the patients' income? Make them younger? Cure their diabetes? I can't see how the identification of factors influencing QOL can help in designing such strategies.

4. The method needs more details (e.g. what kind of random selection method was used? how long had the patients have hypertension? What are the levels of hypertension experienced by the patients? What language was used for the WHOQOL?)

5. What previous validity evidence are there regarding the use of WHOQOL-BREF among Bangladeshi? Internal consistency index (Cronbach alpha) is not a strong evidence for the validity of the scores. Analyses like CFA or Rasch Rating Scale Model are more robust to convince readers of the validity of the scores.

6. For the regression analysis, assumption checks (and the results) need to be stated.

7. The Discussion need to be revamped following a clearer research problem statement (not necessarily 'research gap').

8. The focus on patients with hypertension seem to be diluted given the findings on COVID-19 and diabetes status of the patients. Any conclusion drawn from the study cannot be stated as representing patients with hypertension. The manuscript title is therefore not reflecting the findings.

While the manuscript does not show any fatal flaw, I find it lacking novelty that warrant a publication in a journal. It works well as a routine contemporary updates for Bangladeshi market.

Reviewer #2: The manuscript reads well. Please consider the following minor comments when preparing the revised manuscript.

Typos

"...DOM1 and DOM1 were significantly (p=0.01) associated with their age, education, family type, monthly..."

Methods

1. "...the study was conducted at a randomly selected hospital (Square Hospitals

Limited) from the top 10 hospitals..." Could you please identify the other nine private hospitals included in the study? What criteria were used to rank these hospitals, and what was the rationale for this ranking methodology? Furthermore, what were the reasons for focusing on private rather than public hospitals in this research? Given that private healthcare in Bangladesh can be expensive and often requires insurance, how does the study account for potential biases in representing higher-income populations?

2. how authors come up with USD853.14 as good or bad household income.

3. "...A random sampling technique was employed in this study to ensure the generalizability of the findings." The total number of eligible patients from which the random sample of 300 was drawn. So. the initial patient pool is missing from that statement alone.

4. "...The overall prevalence of hypertensive patients in the Dhaka reflected 31%..."

The observed hypertension prevalence of 31% in Dhaka suggests that odds ratios from logistic regression may not be a good approximation of prevalence ratios. Could you elaborate on why logistic regression was chosen over methods known to directly estimate prevalence ratios, such as Poisson regression with robust standard errors?

5. Include strength and weakness of the study in discussion section

Reviewer #3: The manuscript under review offers a reasonably thorough examination of public health patterns, supported by an adequate sample size (n=300), which meets the conventional minimum threshold for statistical significance. The authors' application of statistical methods throughout the paper is generally appropriate (lines 24–28), though there are persistent issues with terminology usage—most notably the incorrect treatment of plural forms such as "data" (line 22) and "statistics" (lines 24, 28), which detract from the academic rigor.

Early in the manuscript, clarity in definitions would benefit the general readership. For instance, the description in line 43 should be revised to read: “Hypertension, commonly referred to as high blood pressure,” as “hypertension” is the correct clinical term.

There are more substantive concerns regarding methodological transparency. On line 119, the claim that Dhaka was selected through “multi-stage random sampling” raises doubts, particularly when the authors themselves cite the city’s extensive healthcare infrastructure as a benefit. This contradiction suggests convenience sampling may have played a role, undermining the generalizability of the findings.

Similarly, the justification provided for the sample size (line 126) lacks credibility. While the authors imply that their choice of 300 participants is a deliberate methodological decision, it more likely reflects the standard threshold for statistical relevance. Further clarification is needed to distinguish between statistical necessity and genuine methodological reasoning.

The paper mentions that the data collection instrument was “pre-tested” (line 133), but fails to specify critical details—namely, the demographic or size of the test group. It is unclear whether the pre-test was conducted among the study’s target population or a separate group, which raises questions about the reliability and validity of the questionnaire.

On a conceptual level, the discussion around COVID-19 exposure (lines 195–196) appears disjointed. The finding that 59.7% of participants had been exposed to COVID-19 is not inherently surprising and lacks a compelling rationale or comparison benchmark that would make this statistic meaningful.

In terms of structure, there is some redundancy toward the end of the manuscript (lines 321–327), where information is repeated unnecessarily. Additionally, the paper concludes with a statement of limitations (line 329), which, while important, may not be the most impactful way to close the manuscript. A more compelling conclusion could emphasize the broader implications or recommendations, while still incorporating the study’s limitations.

A final critical consideration is whether the paper offers culturally appropriate strategies, as alluded to earlier in the text (line 85). This is a potentially valuable contribution, yet it remains unclear whether such strategies are proposed or substantiated in the discussion.

In summary, the manuscript provides a solid foundation in terms of data collection and statistical analysis but is weakened by inconsistencies in methodological transparency, terminological imprecision, and rhetorical structure. Overall, the study offers a meaningful contribution to multiple disciplines and thus has inherent value to the research community writ large.

Reviewer #4: This manuscript investigates the quality of life (QOL) among hypertensive patients in a selected tertiary hospital in Dhaka, Bangladesh, using the WHOQOL-BREF instrument.

While the study addresses an interesting public health question, it suffers from multiple fundamental flaws related to the representativeness of the study population. Due to these issues in the selection of a highly specific and unrepresentative study site (Square Hospitals Limited), which severely compromises the generalizability and external validity of the findings for the broader hypertensive population in Dhaka, or Bangladesh, this manuscript is not suitable for publication. The conclusions drawn cannot reliably inform public health strategies for the majority of the population. Combined with other methodological and interpretative concerns, these issues warrant Rejection.

A. Fundamental Issues:

1. The study was conducted at Square Hospitals Limited, described as a "leading tertiary care facility" and one of the "top 10 hospitals" in Dhaka with a dedicated cardiac department. Such premier institutions in Dhaka are only accessible primarily to a more affluent segment of the population. This deliberate selection of a high-end, private hospital introduces a significant selection bias. The patient population from such a facility is unlikely to be representative of the general hypertensive population in Dhaka, and certainly not of Bangladesh, where a substantial portion of the populace is underprivileged and relies on public healthcare facilities or less expensive private options.

2. Consequently, the findings regarding QOL and its determinants from this specific, potentially socioeconomically advantaged, patient cohort cannot be generalized to the broader population of hypertensive patients in Bangladesh. The study's conclusions and recommendations, if based on this unrepresentative sample, may be misleading for public health planning and interventions aimed at the general population. The manuscript aims to provide insights for "Bangladesh" (Abstract, Background, Conclusion), but the sampling strategy fundamentally undermines this goal.

3. The manuscript does not adequately acknowledge or discuss the profound limitations imposed by this choice of study site on the external validity of its findings. While the discussion mentions "focusing on specific region (Dhaka) may limit the generalizability," this does not capture the critical issue of socioeconomic selectivity within Dhaka due to the choice of hospital. Furthermore, the authors’ interpretation in multiple instances appear quite out of scope.

B. Rationale and Contextualization

1. While the study mentions the COVID-19 pandemic's impact, the "post-pandemic" aspect could be more clearly defined and integrated. It's unclear what specific timeframe "post-pandemic" refers to in this study and how this phase distinctly influences QOL compared to the pandemic phase or pre-pandemic times.

2. The rationale for choosing WHOQOL-BREF over other instruments like EQ-5D (which the authors mention was used in Indonesia during the pandemic) could be strengthened, particularly in the context of previous HRQOL studies in Bangladesh.

C. Methods

1. Patients were "randomly selected from two departments... using the patient register." Further details on the randomization process are needed. Were all patients in the register eligible? How was systematic bias avoided? Are these two departments (Cardiac & Vascular Surgery and Cardiology) representatives of all hypertensive patients, even within this hospital (e.g., what about patients managed in general medicine or outpatient clinics for hypertension without acute cardiac events)?

2. The proportion (p) used for sample size calculation was 0.76, stated as "the QOL among hypertensive patients expressed by mean score of domains ranging from 0.65 to 0.88, with 0.76 considered as the average" (citing a study from rural Vietnam). Using an average of a range of mean scores as a 'proportion' for sample size calculation for a binary outcome (implied by later categorizing QOL as 'Good/higher' vs 'Poor to moderate/lower') is methodologically questionable. The justification for p=0.76 needs to be clearer and more appropriate for the intended analysis.

3. The manuscript states that poor lifestyle was "measured considering the variables like physical activity, sleeping pattern, deleterious habit etc." (Results, Table 2 footnote). This is vague. The specific components, how they were measured, and how they were combined to classify "poor lifestyle" need to be explicitly detailed in the methods.

4. The scores for QOL domains were dichotomized using 50% as a cutoff ("Scores above 50% were considered as 'Good/higher QOL'; while below 50% as 'Poor to moderate/lower QOL'"). This transformation of a continuous scale into a binary variable can lead to loss of information. Justification for this specific cutoff and the potential impact of this dichotomization should be discussed.

5. Statistical Analysis: The use of backward elimination for regression analysis can be problematic as it may lead to model instability and exclusion of important confounders based on statistical significance rather than theoretical importance.

D. Interpretation and Discussion

1. Given the significant limitation of the study site, any conclusions drawn about the QOL of hypertensive patients in Bangladesh are likely overstated. The discussion should be heavily tempered by this limitation.

2. When comparing findings (e.g., gender not being significant vs. an Ethiopian study where it was), the discussion should consider that the highly selective nature of the current study's sample might explain these discrepancies, rather than just "cultural or regional differences."

3. The study found lower monthly family income was associated with poor QOL. In a sample drawn from a high-end hospital, this "lower income" group is still relatively well-off compared to the general population, making the interpretation of this finding misleading.

**********

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: Yes: Proloy Barua

Reviewer #3: No

Reviewer #4: 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.

Dear Dr. Akter,

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 submit your revised manuscript by  Sep 08 2025 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.

• 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 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,

Md. Feroz Kabir, PhD, BPT, MPT, MPH, BPED, MPED

Academic Editor

PLOS ONE

Journal Requirements:

1. If the reviewer comments include a recommendation to cite specific previously published works, please review and evaluate these publications to determine whether they are relevant and should be cited. There is no requirement to cite these works unless the editor has indicated otherwise.

2. 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:

Thanks for your response according to the reviewers comments. Please properly revise the English and format and submit within  Sep 08 2025 11:59PM.

[Note: HTML markup is below. Please do not edit.]

[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.

Dear Dr. Nasrin Akter,

Please submit your revised manuscript by Jan 11 2026 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.

• 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 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,

Kshitij Karki, MPH, MA

Academic Editor

PLOS ONE

Journal Requirements:

If the reviewer comments include a recommendation to cite specific previously published works, please review and evaluate these publications to determine whether they are relevant and should be cited. There is no requirement to cite these works unless the editor has indicated otherwise.

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):

Please revise as per the suggestions from the reviewers. Thank you

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

Reviewer #2: All comments have been addressed

Reviewer #5: All comments have been addressed

**********

2. Is the manuscript technically sound, and do the data support the conclusions??>

Reviewer #2: Yes

Reviewer #5: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously? -->?>

Reviewer #2: Yes

Reviewer #5: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available??>

The PLOS Data policy

Reviewer #2: Yes

Reviewer #5: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #2: Yes

Reviewer #5: Yes

**********

Reviewer #2: Thank you for addressing all comments in the revised manuscript titled "Quality of Life in hypertensive patients using the WHOQOL-BREF instrument in post pandemic Bangladesh: A cross-sectional study followed analytical approach". I have no further comments

Reviewer #5: Dr. Nasrin Akter and colleagues investigated Quality of Life in hypertensive patients using the WHOQOL-BREF instrument in Bangladesh. The major finding is that hypertensive patients have low QOL in psychological and social domains, with specific factors influencing QOL across all domains.

1. It is recommended that the title be revised to “Quality of Life in hypertensive patients using the WHOQOL-BREF instrument in the post-pandemic Bangladesh: A cross-sectional study”.

2. References 1 and 2 are listed in reverse order, as are References 24 and 25. Please revise these.

3. Line 212 states "Those with frequent no daytime napping were considered to have a poor sleep pattern." Are there any relevant references to support this argument?

4. As mentioned in Line 237, the "thirteen-item index" lacks one item in its parenthetical explanation. Please supplement it.

5. Table 1 and Table 2 are referenced in reverse order: Table 2 is mentioned in Line 279 while Table 1 is referenced in Line 297. Please correct these.

6. As referenced in Line 271, the value "n=269/300" corresponds to a calculated result of 89.7%. Please correct this accordingly.

7. In Table 1, the notation "*Scores < 1SD" appears, but the “*” is missing from the table. Please provide an explanation. Additionally, the position of "Spearman’s correlations (r)" is incorrect. Please adjust it accordingly.

8. It is more appropriate to revise Lines 305 and 306 to "with predominantly low to moderate relationships". Additionally, there is an error in the reference to Table 2 mentioned in Line 306 (before revision).

9. Could you please specify the details of the adjustments made to the model in the regression analysis mentioned in Line 333?

**********

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

Reviewer #5: 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.]

To ensure your figures meet our technical requirements, please review our figure guidelines: https://journals.plos.org/plosone/s/figures

You may also use PLOS’s free figure tool, NAAS, to help you prepare publication quality figures: https://journals.plos.org/plosone/s/figures#loc-tools-for-figure-preparation.

NAAS will assess whether your figures meet our technical requirements by comparing each figure against our figure specifications.

Attachments

Attachment

Submitted filename: PONE-D-25-12356 (11.25).docx

<p>Quality of Life in hypertensive patients using the WHOQOL-BREF instrument in post-pandemic Bangladesh: A cross-sectional study followed analytical approach

PONE-D-25-12356R3

Dear Dr. Nasrin Akter,

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 will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager®  and clicking the ‘Update My Information' link at the top of the page. For questions related to billing, please contact billing support .

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,

Kshitij Karki, MPH, MA

Academic Editor

PLOS One

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

Reviewer #5: All comments have been addressed

**********

2. Is the manuscript technically sound, and do the data support the conclusions??>

Reviewer #5: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously? -->?>

Reviewer #5: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available??>

The PLOS Data policy

Reviewer #5: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #5: Yes

**********

Reviewer #5: (No Response)

**********

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 #5: No

**********