This chapter covers the certain aspects of reactions between antihypertensive drugs and metabolic syndrome. It has become apparent that biomarkers may play a role in the diagnosis and management of cardiovascular disease (CVD). Biomarkers are a reflection of abnormal vascular biology and permit disease and therapeutic monitoring in clinical practice. Biophysical markers of CVD include (but not limited to) central aortic blood pressure (CABP), high-sensitivity C-reactive protein (hs-CRP), adiponectin, cystatin, tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL-6), procollagen, and homeostatic model assessment-insulin resistance (HOMA-IR). The effects of antihypertensive drugs on HOMAIR, hs-CRP, and adiponectin may indicate additional vascular protection over and beyond blood pressure reduction.