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Lifestyle changes associated with reduced physical activity, increased caloric content of food and a steady increase in emotional stress load cause potentiation of risk factors for cardiovascular disease. Metabolic syndrome combines hypertension, dyslipidemia, diabetes and obesity. Primary systemic insulin resistance and concomitant systemic hyperinsulinemia underlie the pathology. Insulin resistance triggers a vicious cycle of symptoms that lead to the emergence of severe cardiovascular complications. Metabolic cascade can also be initiated by obesity, which in its turn predisposes to the development of hypertension and reduction of the sensitivity of peripheral insulin receptors with subsequent accumulation of excess body weight. Treatment of metabolic syndrome should be pathogenetically substantiated and include antihypertensive, lipid-lowering, anti-thrombotic drugs on the background of a rational diet and lifestyle changes.