Bisphenol A (BPA) is a high-volume production chemical that has been suspected to have adverse health effects. Recent studies have suggested that cardiovascular diseases are associated with the BPA exposure. The aim of present study was to investigate the associations of urinary BPA with heart rate variability and blood pressure. We recruited 560 noninstitutionalized elderly citizens from August 2008 to August 2010 in Seoul. All of the participants were ≥60 years old. The participants took medical examinations ≤5 times. Urinary BPA concentration, heart rate variability, and blood pressure were measured at each time. A total of 1511 observations from 521 participants were included in the analyses. We observed that urinary BPA was associated negatively with the root mean square of successive differences for heart rate and positively with blood pressure. The odds ratio of showing hypertension (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg) was 1.27 (95% CI, 0.85-1.88) in the fourth quartile compared with the first quartile of urinary BPA concentration. When the analyses were restricted to participants who did not report previous history of hypertension (n=258), the odds ratio was increased to 2.35 (95% CI, 1.33-4.17).