The urgency of obesity issue is undeniable. Obesity is now considered the most important risk factor of cardiovascular diseases. Numerous studies have demonstrated the negative effect of excessive adipose tissue on structural and functional changes in the heart that lead to development of left ventricular hypertrophy, arrhythmias and conduction abnormalities, as well as progression of diastolic and systolic heart failure. High prevalence of obesity – so high that it can be called a pandemic – greatly contributes to the increased incidence of cardiovascular diseases. Studying the problem of obesity is a priority area of focus for modern medicine. This article describes hormonal, metabolic and hemodynamic features of obesity impact on cardiovascular system and describes pathogenetic mechanisms of cardiovascular pathology development.