Polycystic ovary syndrome (PCOS) is a widespread disease characterized by excessive androgen production, ovarian dysfunction and polycystic ovarian morphology, as well as multiple metabolic disorders. The interrelated effects of hyperandrogenism, obesity, and insulin resistance contribute to the development of hyperglycemia, dyslipidemia, adipokine imbalance, increased inflammatory activity, and the development of oxidative stress in women with PCOS. The listed factors have a detrimental effect on the state of the vascular wall, as a result of which the activity of its components, in particular, the endothelium, changes. Endothelial dysfunction is one of the first steps in the pathogenesis of cardiovascular diseases (CVD). Assessment of the risk of developing CVD and their prevention in the population of women with CVD are mandatory measures. Lifestyle change should be the first step in achieving this goal. In addition, it is necessary to keep in mind the available pharmaceutical support options. © 2025, Media Sphera Publishing Group. All rights reserved.