Introduction: In order to find out the factors associated with BP control patients we have conducted an observational survey: the PERSIST Study (PrEvalence of aRterial hypertenSion In treated hyperteSive patienTs in Romania). Methods: Patients with uncontrolled BP (≥140/90 mm Hg) under at least two drugs were included in the study and reassessed at three month apart. Those with modifications in therapy have formed the study group, afterwards subdivided in a group with central adrenergic inhibitor (CAI) added to the previous therapy and a control group. Results: The rate of BP normalization was 40.7% (159/391): 43% (144/333) under CAI vs 26% (15/58) under any other changes in treatment (p <0,01). Rilmenidine and moxonidine were the CAI preferred by physicians, highly selective for the I1-imidazoline receptor, with little effect on the central alpha2-receptor. The binomial logistic regression has validated as statistically significant predictors of BP normalization the presence of CAI in the therapeutic regimen (p <0,001) and the stage of hypertension at baseline (p<0,01). Toleration of selective CAI was very good in comparison with other therapeutic regimens. Conclusions: Although the actual guidelines are indicating CAI as fourth line therapy in hypertension, few studies have evaluated the contribution of the new class agents to BP normalization in combination with other drugs. PERSIST study is emphasizing the efficiency and safety of imidazole agonists in any stage of hypertension and support their recommendation in uncontrolled BP under current treatment.