Galectin-3 Promotes Vascular Remodeling and Contributes to Pulmonary Hypertension

0.727-0.840),but mortality in women who used CPAP increased (odds ratio, 1.320; 95% confidence interval, 1.151-1.515).In men, significant interactions were found for cerebrovascular disease, diabetes mellitus, and hypertension, but patients treated with CPAP had a lower probability of death than control subjects in all scenarios (Table 1).On the other hand, CPAP treatment was associated with lower mortality in women with cerebrovascular disease but had a neutral or detrimental effect on mortality in other scenarios (Table 1).Overall, the population of patients treated with CPAP in Catalonia had lower mortality rates than age-, sex-, and regionmatched control subjects, despite a higher prevalence of most comorbidities among patients treated with CPAP.However, this finding was driven by the 74% of men in the population, because CPAP was associated with increased mortality among women.These population-based findings contrast with the less positive findings of the randomized SAVE study (3).In contrast, our results are consistent with recently published data from a Danish historical cohort (22,135 patients with OSA), which showed that CPAP treatment was associated with lower mortality rates in middle-aged and elderly men after adjustment for multiple comorbidities, but not in women (5).Although in our population sex differences in the results seem to be related to a high heart failure prevalence among women using CPAP, further research is needed on the potentially different characteristics of OSA, and associated comorbidities, among women and men.Finally, several potential limitations should be noted.First, the data used in this study lack information about CPAP adherence.Second, it was not possible to control for undiagnosed OSA in control subjects, and, finally, the observational design means that potential confounding from uncontrolled factors such as socioeconomic status, level of health literacy and self-care, or level of delivered health care cannot be avoided.In conclusion, these findings suggest that CPAP treatment is associated with reductions in mortality at the population level, although only in men.Therefore, further analyses should be planned within the frame of precision medicine (6) to clarify which patients with OSA could benefit the most from CPAP treatment and whether CPAP might be detrimental in some specific patient subgroups.