To evaluate demographic, diagnostic, and treatment characteristics of patients with concomitant hypertension and dyslipidemia, stratified by body mass index (BMI) and the attainment of blood pressure (BP) and lipid targets in obese versus non-obese patients. This retrospective study utilized data from 2004 to 2011 from the GE Centricity Electronic Medical Records database of a primary care physician group in Southwestern Pennsylvania. Patients having ‘active’ status (with one or more visit(s) to the physician), ≥18 years of age, and having concomitant hypertension and dyslipidemia (identified based on diagnosis, medication, and BP/lipid measurements) were included. Patients were classified into three cohorts based on their BMI: normal-weight (≤24.9 kg/m2), overweight (25.0-29.9 kg/m2), and obese (≥30.0 kg/m2). Goal attainment for BP and lipid levels were assessed based on JNC 7 and NCEP ATP III guidelines, respectively. Univariate and multivariate analyses were conducted to compare BP and lipid goal attainment in obese versus non-obese. A total of 9,086 patients with concomitant hypertension and dyslipidemia were identified and categorized as normal weight (13.8%), overweight (33.7%) and obese (52.5%). Patients who were obese were younger (<65 years); more likely to have diabetes (P<0.001); had higher baseline BP, triglyceride levels and lower HDL-C (P<0.05); and more likely to be prescribed both antihypertensives and antilipemic agents (P<0.001). In multivariate analyses, obese patients were significantly more likely to fail to attain BP (OR=1.562, P<0.001) and dual BP and LDL-C (OR=1.193, P=0.023) goals as well as optimal levels of triglycerides (OR=1.864, P<0.001) and HDL-C (OR=1.933, P=0.009). Obesity appears to be an independent risk factor for the failure to attain BP and dual BP and LDL-C goals in patients with concomitant hypertension and dyslipidemia. These findings suggest that future research is needed to determine the underlying link between obesity and failure to attain these goals.