Simultaneous presence of the risk factor cluster, the frequent situation in the individual patient, represents every-day problem for the diagnostics and treatment of various serious clinical conditions together (arterial hypertension, impairment of glucose tolerance, type 2 diabetes mellitus, obesity, abnormalities in lipid spectrum, smoking abuses, physical inactivity and other risk factors). The current international guidelines, Slovak Lipid consensus-2 and its Actualization represent the background of the stratification. The basic data of cardiometabolic risk profile may be determined by using SCORE Card ESC and by measuring the waist circumference. Actual scientific knowledge concerning the central abdominal type of obesity change the view on the evaluation of overweight, obesity, especially in the high risk individuals. Adipocytes as the endocrine and metabolic active cells significantly affect the metabolic status and these activities elevate the effect on other risk factors for the atherosclerotic process development. In the paper we analyze the relations of type 2 diabetes mellitus, renin-angiotensin-aldosterone system, arterial hypertension, effect of endocanabinoid system and metabolic syndrome on atherosclerotic progress. The pathophysiologic connection of cardiovascular and metabolic risk, currently called “cardiometabolic risk” represents not only the research interest but also every-day need of clinical practice during the patients’ evaluation and management with risk factors.