BACKGROUND: PCOS is associated with risk factors for premature atherosclerosis. OBJECTIVE: To determine risk factors for coronary artery disease (CAD) among Sri Lankans with PCOS. METHOD: Cross sectional observational case control study of consecutive consenting Sri Lankans with PCOS (80) and controls (45) attending a specialist endocrine clinic in Colombo. OUTCOME MEASURES: BMI & waist: hip ratio (WHR), prevalence of metabolic disease, resting blood pressure, degree of insulin resistance, plasma lipids and fasting plasma total homocysteine (Hcy). RESULTS: Among the PCOS women, 5/80 (6.25 percent) had hypertension, 6/80 (7.5 percent) Type 2 diabetes. PCOS versus controls Mean age 27.3 ñ1. 7 vs. 33 ñ 4.7 (p= 0.003); BMI 26.3 ñ 0.95 vs. 23.1 ñ 0.06 (0.04); WHR 0.95 ñ 0.01 vs. 0.79 ñ 0.03 (p= 0.03). Excluding hypertensives mean Systolic BP 130 vs. 110 (p= 0.02) & Diastolic BP 86 vs …