Obesity (the most common metabolic disease) and arterial hypertension (the most common cardiovascular disease) are often occurring together, which brings very high cardiometabolic risk, i.e. risk for atherosclerotic vascular diseases and type 2 diabetes. Hypertension in obese patients is often resistant to drug treatment, represents the salt sensitive hypertension and many organ damages and other diseases are present. The common pathophysiological mechanisms of the both diseases are mentioned. Those mechanisms stimulate the development of macro- and micro-vascular complications and from those mechanisms arise the management of hypertension in obese patients. Combination of ACE inhibitor and metabolically neutral diuretic indapamide seems to be suitable for the pharmacological treatment of hypertension in obese patient.