Background: Overactivity of the sympathetic nervous system plays an important role in a pathophysiological mechanism of heart failure with preserved ejection fraction characteristic for hypertensive patients. Modulation of its activity can influence on diastolic dysfunction grade and represent a major interest for scientist. Purpose: Comparison evaluation of the impact of central and peripheral SNS blockers on degree of diastolic dysfunction in patients with resistant hypertension: selective I1-imidazoline agonist Moxonidine versus cardioselective beta-blocker Bisoprolol. Methods: 100 patients with resistant hypertension and different degree of diastolic dysfunction after a 3 week standardized treatment with Losartan 100 mg, Amlodipine 10 mg and Indapamide 1.5 mg were randomly assigned into two equal groups, depending on medication supplemented to the previously administered: I M group – Moxonidine 0.3 - 0.6 mg and II B group - Bisoprolol 5 – 10 mg. To determine the degree of diastolic dysfunction patients underwent an echocardiographic examination at baseline, 3, 6 and 12 month of continuous treatment. Results: Examination of patients at the initial stage noted the presence of grade 1 diastolic dysfunction in 36 (72%) patients from I M group and 44 (88%) patients from II B group, grade 2 diastolic dysfunction – in 14 (28%) and 6 (12%) patients from group I M and II B, respectively, without difference between groups. A statistically significant dynamics in improving the degree of diastolic dysfunction appears starting with 6 months of continuous treatment in both groups, the beneficial effect being maintained until the end of the study (Tab.1). Conclusions: Both treatment schemes have a positive lusitropic effect in patients with resistant hypertension. Although group treated with Bisoprolol has higher potency in improving diastolic function of LV, it did not have statistical authenticity compared to group of Moxonidine treatmen.