Osteoarthritis is a common degenerative disease with many risk factors like age, obesity and gender, which are known to contribute to its development. However, the pathophysiology of the disease is still largely unknown. As osteoarthritis and cardiovascular disease (CVD) share many common pathophysiological aspects, it is important to investigate their relationship. In addition to mechanical wear and tear, also inflammation, vascular pathology and adipokines seem to play an important role in the pathogenesis of OA. Thus it is possible that altered arterial wall properties (e.g. endothelial dysfunction, increased arterial stiffness and intima-media thickness) and changes in inflammatory biomarkers are potential links betweeen CVD and OA. This article gives a brief contemporary overview of the roles of vascular function and inflammatory adipokines in the pathogenesis of OA.