Characteristic of included studies.

The association between Vitamin D Receptor (VDR) gene polymorphisms and essential hypertension (EH) remains controversial. We searched databases (Cochrane Library, EBSCO, EMBASE, LILACS, ProQuest, PubMed, Science Direct, Springer) for studies on VDR gene polymorphisms and EH until May 30, 2024, following PRISMA guidelines. RevMan 5.4.1 provided pooled odds ratio (OR) under Hardy-Weinberg Equilibrium based on allele, additive, dominant, and recessive genetic models. Meta-regression was performed using Comprehensive Meta Analysis V3. Twenty-two studies from thirteen countries were analyzed. The recessive model suggested lower EH risk in individuals with the recessive allele (bb) of BsmI (OR: 0.81; 95%CI, 0.69 to 0.94, p = 0.007; I2 = 35%, p = 0.13). No significant associations were found for FokI, ApaI, and TaqI polymorphisms. Methodological quality significantly influenced EH risk associated with the FokI polymorphism across allele, additive, and dominant models (All p<0.0005). Male proportion influenced EH risk in the additive model for the FokI polymorphism (p = 0.0235), while age impacted risk in the recessive model (p = 0.0327). FokI polymorphism’s influence on EH risk varies by sex, age, and study quality. BsmI polymorphism is independently associated with lower EH risk in recessive homozygotes, with no significant associations found for ApaI and TaqI polymorphisms.