Aim Current study aimed to investigate the sex‐stratified secular trend of cardiovascular disease risk factors among an older population in Iran during a median follow‐up period of 8.76 years. Methods A total of 1490 participants (733 women) aged ≥60 years were evaluated in four study phases of 2002–2005, 2005–2008, 2008–2011 and 2011–2014. The trends of cardiovascular disease risk factors for each sex were estimated using generalized estimating equations. Results The age‐adjusted prevalence of diabetes, hypertension, central obesity, and chronic kidney disease at the baseline was 24%, 43%, 55%, and 32% in men and 31%, 57%, 60% and 53% in women, respectively, and had noticeable upward trend during the study period to reach 35%, 56%, 61% and 51% in men, and 42%, 71%, 74% and 67% in women, respectively. However, lipid profile parameters showed favorable trends. Despite the increasing trend in drug consumption, approximately 27% of women with diabetes and 37% of men with diabetes did not use antidiabetic medication, respectively; the results were 23% and 35% for hypertensive women and men, respectively. Among men, there was a decreasing trend towards low physical activity, from 40% at baseline to 26% at the most recent follow up. The prevalence of smoking remained steady throughout follow up. Conclusions Despite the benefits of lipid lowering, the status of other risk factor profiles are often suboptimal in both sexes. There remains much room for improvement in risk factors management, particularly for hypertension, smoking and adiposity status, and a need for an intervention. Geriatr Gerontol Int 2017; ••: ••–••.