The aim of this study was to investigate the relation between hypotension and slowly developing hearing impairment, using otoacoustic emissions. A group of 42 patients was examined, with diastolic blood pressure < or = 60 mmHg and systolic blood pressure < or = 105 mmHg. The subjects underwent biochemical, cardiological, ENT and audiological examinations. Distortion product otoacoustic emissions (DPOAE) were recorded in the format of DP-gram. The results were compared to the data of 30 normal persons of similar age and sex, examined at the same laboratory. Audiometric results showed that 18 patients had mild or moderate symmetrical hearing loss in one or more frequencies, mainly in the lower frequency range. DPOAE of the patients had reduced amplitude as compared to controls or were even absent, in one or more frequencies. It may be concluded that a hypotensive condition could be a possible factor in the origin of cochlear damage and DPOAE may be useful in monitoring hypotensive patients.