To examine the impact of highly active antiretroviral therapy (HAART) and associated factors on blood pressure (BP) of naive patients after 2 years of treatment. Observational cohort study of 227 patients initiating their first HAART regimen. We evaluated mean blood pressure (BP) and demographic, epidemiological, clinical, immunologic and biochemical characteristics related to HIV infection prior to HAART and at 2 years. High blood pressure (HBP) [systolic BP (SBP) ≥140mm Hg and/or diastolicBP (DBP) ≥90mm Hg] was defined according to international criteria. Of the 227 patients, 51% were men, majority 81% had AIDS, 26% had HBP and their mean age was 40 years. At 2 years the prevalence of HBP was 31.7%. The corresponding changes in SBP, DBP and pulse pressure (PP) among hypertensive and normotensive group was 3.47±15.21 vs -0.71±16.28 (P=0.08), 1.81±10.12 vs 1.0±11.39 (P=0.625) and 1.67±14.14 vs 1.71±12.08 (P=0.982) respectively. Univariate analysis showed that HBP was associated with older age, male gender and higher baseline triglyceride. A linear regressionmodel adjusting for age and sex suggested a significant impact of older age and male gender. We observed high prevalence of hypertension in our cohort, the pattern persisted in an upward trend after 2 years. The increase in BP depended on age, male gender baseline triglyceride. Blood pressure shouldbe periodically measured and treated when necessary in HIV-infected patients on HAART.