Compromised autoregulation of ocular blood flow is a plausible consequence of hypertension, and studies indicate that hypertension can lead to progression of glaucoma. Initiating antihypertensive therapy in subjects with long-standing hypertension could deteriorate ocular blood flow leading ultimately to glaucomatous damage. Evidence on this topic is still equivocal but until adequate knowledge on the field has been established we recommend referral of patients disposed for glaucoma to ophthalmologic examination when initiating antihypertensive medication.