Cardiovascular drugs are the most commonly prescribed therapeutic classes among older adults, reflecting the high burden of cardiovascular diseases in those patients. Prescribing in elderly people is challenging due to age-related physiological changes, geriatric syndromes, and multi-morbidity. Identifying risk factors associated with medication use is imperative to improve medication management, reduce the risk of medication errors, and optimize therapeutic outcomes. The aim of the present study was to explore medication-related risk factors among a group of older patients. A cross-sectional study was conducted using convenience sampling method to enroll hospitalized older patients attending the Cardiac Care Unit of Baquba Teaching Hospital in Diyala province from December 2024 to February 2025. Risk factors were estimated through the validated Medication Risk Questionnaire (MRQ). A total of 200 patients were included in the study, of whom 111(55.5%) were female. The median age (interquartile range) was 71 (68-74) years. Using more than five medications (89.5%), having more than one physician involved in their healthcare (39.5%), using medications for three or more different health conditions (63.5%), using narrow therapeutic index medications (36.5%), and frequent changes to their medication regimen (35%) were among the types of detected risk factors. Based on MRQ, various factors that may place older patients at risk for drug-related problems had been identified. These findings underscore the need for multi-faceted interventions like periodic structured medication review, medication reconciliation, and applying de-prescribing practices to avoid problematic polypharmacy, ensure the rational use of medications, and reduce unnecessary healthcare utilization.