Because PCOS can increase the risk of cardiovascular disorders, referral to a cardiovascular specialist for prevention of cardiovascular disorders is necessary if women with PCOS have any of the following: A family history of early-onset cardiovascular disorders Cigarette smoking Diabetes mellitus Hypertension Dyslipidemia Sleep apnea Abdominal obesity (as for metabolic syndrome) Clinicians should evaluate cardiovascular risk by determining body mass index (BMI), measuring fasting lipid and lipoprotein levels, and identifying risk factors for metabolic syndrome.