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The prevalence of overweight (currently defined as body mass index (BMI) >25 kg/m2) and obesity (BMI >30 kg/m2) is rapidly increasing and has been associated with increased morbidity and mortality. Obesity is associated strongly with insulin resistance and type 2 diabetes, which are major risk factors for hypertension and cardiovascular disease. Recent evidence has emerged that adipocytes function as highly active endocrine cells and secrete a wide range of inflammatory and vaso-active agents. These include leptin and adiponectin which appear to display a range of effects on the cardiovascular system, particularly in vitro. A better understanding of the roles for these and other adiopcyte derived agents in cardiovascular disease pathogenesis may lead to the development of better prevention strategies and novel therapies.