In the article it is shown, that occurrence of various forms of arterial hypertension (АH) in children with obesity and hypothalamic syndrome is associated with the degree of insulin resistance. "A white dressing gown" hypertension was registered 2,5 times more often among children with obesity without insulin resistance while liable and stable forms of AH - 2,8 times more often in children with a metabolic syndrome. It is necessary to include children with obesity and "a white dressing gown" АH, in the group of high risk of true АH development. In children and teenagers with metabolic syndrome and with AH stable forms marked changes of сircadian rhythm of the arterial pressure (AP) indicated a decrease in AP at night (nondippers) and a night hypertension (night-peakers). The data provide evidence of cardiovascular system failure in regulation of a vascular tone when accompanied by pronounced insulin resistance.