Avalilação PREreview Estruturada de Combination Therapy in Hypertension: Renin-Angiotensin-Aldosterone System Inhibitor with a Diuretic or Calcium Channel Blocker

Does the introduction explain the objective of the research presented in the preprint?

Partly

In the current preprint, the introduction states: “This paper’s goal is a comparative analysis of the most frequently used combination: RAAS inhibitor with diuretics or a calcium channel blocker.” This sentence mentions the objective (comparing RAAS+diuretic vs. RAAS+CCB) but does not fully elaborate why this is clinically relevant, what knowledge gap it addresses, or what the author expects the reader to learn from the analysis. High-impact journals expect the introduction to frame the problem, articulate the gap, state the objective clearly, and briefly justify the approach. Thus, the objective is present but underdeveloped.

Are the methods well-suited for this research?

Neither appropriate nor inappropriate

This manuscript is a narrative review, not a primary research study. The “methods” consist of summarizing mechanisms, citing clinical trials, and listing guideline recommendations. However: The author does not describe a systematic search strategy, inclusion/exclusion criteria, or quality appraisal of the trials — which are best practices for reviews. There is no mention of PRISMA guidelines or protocol registration, and the critical appraisal of evidence is minimal. Yet, the summary of data is factually correct and reasonable for the stated aim. So while the methods are sufficient for a descriptive overview, they fall short of rigorous review standards expectedby high impact journals.

Are the conclusions supported by the data?

Somewhat supported

The author concludes that: RAAS–CCB is superior to RAAS–diuretic combinations for cardiovascular outcomes, citing ACCOMPLISH and other trials. Combination therapy is more effective than monotherapy. These conclusions are generally aligned with the cited evidence, particularly the ACCOMPLISH trial. However: The manuscript does not critically address limitations of the trials, heterogeneity of populations, or alternative interpretations. It also generalizes findings without nuanced discussion of patient subgroups, adverse effects, or cost-effectiveness. Thus, the conclusions are broadly supported by the data but would benefit from more critical appraisal and acknowledgment of uncertainties.

Are the data presentations, including visualizations, well-suited to represent the data?

Neither appropriate and clear nor inappropriate and unclear

The manuscript includes tables and references to figures, but these are basic and not professionally designed. The figures (e.g., pathways of RAAS, drug mechanisms) are text-heavy and not sufficiently visual, lacking clarity for readers unfamiliar with the details. Tables summarize trial results and drug combinations, but they are crowded and would benefit from better formatting, clearer headings, and visual hierarchy. There is no use of forest plots, summary graphs, or consistent formatting that would make trends and comparisons obvious — which is standard in high-impact journals. In short, the data are there, and the intent to illustrate them is present, but the execution is not optimal and could confuse readers.

How clearly do the authors discuss, explain, and interpret their findings and potential next steps for the research?

Neither clearly nor unclearly

The author summarizes findings from clinical trials and states that RAAS–CCB combinations are superior to RAAS–diuretic combinations in certain outcomes. However, the discussion is descriptive rather than interpretive — it lists results without much depth, critical analysis, or exploration of the implications. The manuscript lacks a robust section on limitations, unanswered questions, or concrete recommendations for future research. So while the findings are mentioned and some implications are hinted at, they are not explained with the depth, clarity, and insight expected at high impact journal standards.

Is the preprint likely to advance academic knowledge?

Moderately likely

The manuscript does a good job of summarizing established evidence and explaining mechanisms and trial data. However, it does not present new findings, original hypotheses, or novel interpretations — it’s essentially a well-researched narrative review. It may be useful as a teaching resource or a concise reference for clinicians, but it does not substantially advance academic knowledge beyond what is already established by the ACCOMPLISH, ASCOT, ADVANCE, etc., trials and existing guidelines.

Would it benefit from language editing?

Yes

The manuscript contains frequent grammatical errors, awkward constructions, and overly long, dense sentences. Examples include: “pronounce vasodilation” → likely meant “pronounced vasodilation”. “biggest α1 subunit” → inappropriate register, should be “largest” or more precise. Repeated use of passive voice, redundant phrases, and inconsistent terminology. These issues reduce readability and professionalism. Comprehensive language editing by a professional scientific editor is essential.

Would you recommend this preprint to others?

Yes, but it needs to be improved

The preprint demonstrates substantial effort, thorough literature review, and sound understanding of the topic. However, it suffers from lack of focus, verbosity, insufficient critical analysis, unpolished language, and figures/tables that do not meet high-impact journal standards. With substantial revision — shortening, clearer objectives, critical discussion, professional figures/tables, and language editing — it could become a solid review suitable for a good clinical or pharmacology journal

Is it ready for attention from an editor, publisher or broader audience?

No, it needs a major revision

The manuscript is not yet at the level expected for submission to a high-impact journal or presentation to a broader audience. It requires major revisions in: Language and style (to meet professional, readable standards). Figures and tables (to meet clarity, accessibility, and publication quality). Focus and conciseness (remove unnecessary detail, sharpen key messages). Critical analysis (beyond summarizing — interpret evidence, discuss limitations, and propose future directions).

Competing interests

The author declares that they have no competing interests.

Use of Artificial Intelligence (AI)

The author declares that they used generative AI to come up with new ideas for their review.