This article discusses the findings of a decade-old study on blood pressure among a tribal population in north Sikkim. These findings continue to be relevant today. Hypertension is a significant problem in this region. However, the local health institutions do not identify this as an important health problem and do not include it in their regular preventive and curative health care agenda. Community-based primary health care in India in such a situation must formulate innovative approaches to address the major health needs of the community. The ethics of primary health care rest on this approach.