not much difference its just vista has to much security asking for your permission with everything you do and one odd thing it will ask is for example if you want to install a specific program it will ask for administrator permissions ...why would it do that if your the administrator? the purpose of this hidden account is that you wont have to deal with any of that like i said in the first post 'this is the real Administrator account' alot of people i know hate vista and switch back to xp for this exact issue, but this solves there problem the right way.
i hope this answered your question
EDIT: yes i do know you can disable UAC i did this but i still had some issues i noticed some applications wouldn't run unless i right clicked them and click 'run as administrator' i would notice that the application would run but not correctly unless i did that. the hidden account also solves that problem