It is now well established that high blood pressure is a feature of the metabolic syndrome, and it has been reported that the metabolic syndrome is present in up to one third of hypertensive patients. In this regard, Yanai et al. discussed the mechanisms responsible for the development of hypertension in the metabolic syndrome. Specifically, the authors explored the influence of factors such as visceral adiposity, insulin resistance, sympathetic overactivity, oxidative stress, endothelial dysfunction, activated renin-angiotensin system, increased inflammatory mediators, and obstructive sleep apnea.