Colorectal polyps (CPs) are recognized precursors of colorectal cancer (CRC), which remains a major global public health challenge, ranking third in incidence and second in cancer-related mortality worldwide. This study investigated the associations of hypertension and the zinc finger MIZ-type containing 1 antisense RNA 1 (ZMIZ1-AS1) variant (rs704017) with the odds of CP among participants in the Taiwan Biobank (TWB). Data from the TWB (2008-2015) were linked to the National Health Insurance Research Database (NHIRD, 1998-2015), yielding 8970 participants aged 30-70 years. Multiple logistic regression models were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for CPs according to hypertension status and rs704017 genotype. The distribution of ZMIZ1-AS1 rs704017 genotypes differed significantly between CP cases and controls (p = 0.001). Individuals carrying the rs704017 AG + GG genotype had higher odds of CPs than those with the AA genotype (aOR = 1.39, 95% CI: 1.16-1.66). Hypertension alone was not significantly associated with CP odds; however, a significant interaction was observed between hypertension and rs704017 (p = 0.029). Compared with non-hypertensive individuals with the AA genotype, the aOR was 1.62 (95% CI, 1.29-2.03) for non-hypertensive individuals with AG + GG, 1.45 (95% CI, 1.09-1.95) for hypertensive individuals with AA, and 1.56 (95% CI, 1.16-2.08) for hypertensive individuals with AG + GG. In conclusion, the ZMIZ1-AS1 rs704017 AG + GG genotype was independently associated with increased odds of CP, whereas hypertension alone was not. However, the association between the rs704017 variant and CP appeared stronger among individuals with hypertension, suggesting a potential interaction between genetic susceptibility and hypertension.