The article substantiates the need for adequate fixed combination therapy for metabolic syndrome and arterial hypertension (AH). The issues of inflammation in the initiation and stabilization of arterial hypertension in patients with metabolic syndrome (MS) are considered. Taking into account the results of international and Russian studies, a differentiated approach is proposed to select a fixed combination of antihypertensive drugs for the treatment of hypertension and prevention of cardiovascular complications in patients with MS.