Objective: An analysis of antihypertensive drugs in patients with comorbidities, namely, arterial hypertension (AH), type 2 diabetes mellitus, obesity, indicates that the complex treatment of these patients should include drugs that inhibit excessive activation of the renin-angiotensin-aldosterone system, in particular, angiotensin converting enzyme (ACE) and angiotensin II receptor blocker (ARB II). Numerous scientific data have established that angiotensin II is the main effector mediator of the RAAS, and ACE inhibitors do not fully inhibit the synthesis of angiotensin II. ARB II, their advantages over ACE inhibitors should be emphasized by their ability to reduce the effects of angiotensin II, regardless of the ways of its formation, aim of this study was to compare the results of treatment of patients with comorbidities Design and method: 56 patients of middle age (64.4 ± 1.1) years old, men/women—43%/57% were examined and treated. Arterial hypertension was diagnosed, according to the recommendations of the International Society of Hypertension (ISH), 2020. The type 2 diabetes mellitus, obesity were diagnosed on the basis of clinical, instrumental, biochemical criteria, in accordance with the recommendations of WHO experts, the European Society of Endocrinologists. Results: After treatment for three months, there was a significant decrease in systolic blood pressure (SBP) (by 19.6%), diastolic blood pressure (DBP) (by 15%), and heart rate (HR) (by 9%). From the side of echocardiographic characteristics, the following levels have decreased: EDV—by 25.5%, ESV—by 17.3%, EDD—by 24.0%, ESD—by 12.6%, LVMM—by 8.3%; LVEF has increased by 6% compared with the indicated indicators before treatment. There were no significant differences between such indicators as fasting blood glucose, HbA1c, insulin, TChC, TG, HDL cholesterol, AI; however, a significant decrease was found after treatment in the levels of VLDL cholesterol and BMI. Conclusions: Treatment of arterial hypertension in patients with type 2 diabetes mellitus and obesity with the inclusion of ramipril or telmisartan in the standard therapy had a positive effect on the structural and functional parameters of the left ventricle and ejection fraction. At the same time, the neutral effect of these drugs on carbohydrate metabolism in the examined category of patients has been determined.