Background <p>Hypertension is a global health concern, particularly among middle-aged and older adults. This study aims to fill this gap by examining hypertension prevalence and risk factors using data from the Longitudinal Ageing Study in India (LASI).</p> Methods <p>This study used data from the LASI, which is a nationally representative Longitudinal Ageing Study in India (LASI), wave-1 (2017–2018). Our study included a sample of 12,920 individuals from tribal communities who were aged 45 and above. A binary logistic regression analysis was performed to investigate the factors associated with hypertension in middle-aged and elderly tribal adults using STATA software.</p> Results <p>The study revealed that the prevalence of hypertension among middle-aged and older tribal adults was 34.35%, with 31.97% among males and 36.29% among females. The prevalence of hypertension among middle-aged tribal adults was observed to be 28.67%, while among older tribal adults, it was found to be 46.13%. Age is a prominent factor, showing a marked increase in hypertension risk with advancing age. Individuals aged 51–55 have a cOR of 1.35 (1.03–1.75) and an aOR of 1.37 (1.01–1.86). Gender analysis reveals that females exhibit a higher crude risk with a cOR of 1.21 (1.02–1.42).</p> Conclusion <p>Hypertension is associated to factors such as increasing age, BMI, physical inactivity, tobacco use, and diabetes. Sociodemographic factors like education and socioeconomic status also contribute to the prevalence of hypertension. Targeted public health interventions, including lifestyle modifications, early diagnosis, and management, particularly in tribal communities, can significantly reduce hypertension prevalence and impact. Culturally tailored health promotion programs could further address these risk factors.</p>