Why PAD Is More Common After Age 60

As we get older, it’s common to notice changes in our bodies. We might move a bit slower, feel aches in places we didn’t before, and find that some activities require more effort. Many people accept these changes as an inevitable part of aging. However, some symptoms, particularly persistent leg pain or fatigue when walking, should not be dismissed so easily. These can be warning signs of a serious circulatory condition called Peripheral Arterial Disease (PAD), and your risk of developing it increases significantly after you turn 60.

PAD occurs when the arteries that supply blood to your limbs—most often the legs—become narrowed by a buildup of fatty plaque, a process called atherosclerosis. This reduction in blood flow can lead to pain, non-healing wounds, and in severe cases, amputation. While PAD can affect people at any age, the cumulative effects of lifestyle and the natural aging process of our blood vessels make it far more prevalent in older adults.

Understanding why age is such a primary risk factor is crucial for proactive health management. At Fox Vein and Vascular, we believe that knowledge is power. This guide will explore how the aging process itself affects your arteries, how lifelong risk factors compound over time, and why early PAD diagnosis and treatment are essential for maintaining mobility and quality of life in your later years.

The Aging Artery: A Natural Target for Disease

Our arteries are not static pipes; they are dynamic, living tissues that change throughout our lives. When we are young, our arteries are typically smooth, flexible, and elastic. They can easily widen and constrict to manage blood flow and pressure. However, as we age, our vascular system undergoes predictable changes that make it more susceptible to disease.

1. Endothelial Dysfunction

The inner lining of our arteries, the endothelium, is a critical gatekeeper of vascular health. It produces substances that keep the artery relaxed and prevent blood clots. With age, the endothelium’s ability to function correctly declines. It produces less nitric oxide, the key molecule responsible for vasodilation (the widening of arteries). This leads to vessels that are stiffer and less responsive, a condition that contributes to high blood pressure and makes it harder for blood to flow freely. This age-related decline creates a vulnerable environment where plaque can more easily form.

2. Arterial Stiffness (Arteriosclerosis)

Over decades, the structural proteins in the artery walls, like collagen and elastin, begin to degrade and change. Elastin fibers fray, and collagen becomes cross-linked and stiff. This process, known as arteriosclerosis or “hardening of the arteries,” is a natural consequence of aging. Stiff arteries are less able to absorb the pressure from each heartbeat, leading to an increase in blood pressure. This constant, elevated pressure further damages the delicate endothelial lining, accelerating the buildup of plaque that characterizes atherosclerosis.

3. Increased Inflammation

Aging is associated with a state of chronic, low-grade inflammation throughout the body, sometimes called “inflammaging.” This systemic inflammation affects the blood vessels, making them more prone to injury and plaque formation. Inflammatory cells are a key component of the atherosclerotic plaques that cause PAD. As we get older, this underlying inflammatory state provides a fertile ground for arterial disease to take root and progress.

These natural aging processes mean that even in a perfectly healthy person, the vascular system is more vulnerable after age 60 than it was at age 30. However, most people do not arrive at age 60 with a perfectly clean slate. The real danger comes when these natural changes are combined with decades of exposure to other risk factors.

The Compounding Effect of Lifelong Risk Factors

The primary reason Why PAD Is More Common After Age 60 is that the damage from major risk factors is cumulative. Decades of exposure to factors like smoking, high cholesterol, high blood pressure, and diabetes inflict continuous damage on the arteries. By the time a person reaches their 60s, this accumulated damage, layered on top of the natural aging of the arteries, often reaches a tipping point where symptoms begin to appear.

The Decades-Long Impact of Smoking

Smoking is the single most powerful risk factor for PAD. A person who has smoked a pack a day for 40 years has subjected their arteries to a relentless chemical assault. The toxins in cigarette smoke directly damage the endothelium, promote inflammation, and make the blood thicker and more prone to clotting. By age 60, this long-term damage has significantly accelerated the process of atherosclerosis, leading to more severe and extensive blocked leg arteries.

The Silent Damage of High Cholesterol and Blood Pressure

For many years, high cholesterol and high blood pressure can be completely asymptomatic. A person might live with elevated levels for 20 or 30 years without realizing it. During that entire time, excess cholesterol is being deposited into the artery walls, and high pressure is causing wear and tear on the endothelial lining. By the 60s, the plaque that began forming in one’s 30s or 40s may have grown large enough to cause a significant blockage, leading to the classic PAD symptoms like claudication (leg pain when walking).

The Destructive Force of Diabetes

Diabetes is a major accelerator of PAD. The high blood sugar levels associated with diabetes damage blood vessels throughout the body. For an older adult who has lived with diabetes for many years, the combined effect of high glucose, arterial stiffness, and often co-existing high cholesterol creates a perfect storm for severe PAD. This is why a diabetic foot ulcer/wound is such a common and dangerous complication in older adults, as the combination of poor blood flow in legs and nerve damage (neuropathy) can lead to rapid tissue breakdown.

Recognizing PAD Symptoms in Older Adults

One of the challenges in diagnosing PAD in the over-60 population is that its symptoms are often mistaken for other age-related conditions.

• “It’s just arthritis”: Many older adults assume their leg pain is due to osteoarthritis. However, the pain from PAD (claudication) has a distinct pattern: it occurs with exertion and is relieved by rest. Arthritis pain is often more constant and can be worse in the morning.
• “I’m just getting slower”: A gradual decrease in walking speed or endurance is often accepted as a normal part of aging. In reality, it can be the body’s way of compensating for leg circulation problems. The person unconsciously slows down to avoid triggering pain from oxygen-starved muscles.
• “My feet are always cold”: While some people naturally have colder extremities, a new or worsening sensation of coldness in one foot compared to the other is a red flag for reduced blood flow.

As PAD progresses, the symptoms become more severe and harder to ignore.

• Ischemic Rest Pain: This is pain in the feet or toes that occurs at night while lying down. It’s a sign of advanced disease and indicates that the tissues are not getting enough blood even at rest.
• Non-Healing Wounds: A minor cut, blister, or sore on the foot or ankle that fails to heal is a vascular emergency. This indicates Critical Limb Ischemia (CLI), the most severe form of PAD, and carries a high risk of gangrene and amputation. Any foot ulcer, toe ulcer, or leg wound in an older adult demands immediate evaluation by a PAD specialist.

Why Early Diagnosis and Treatment Are Crucial

For an older adult, mobility is intrinsically linked to independence and quality of life. The ability to walk to the store, visit friends, or simply move around the house without pain is vital. PAD directly threatens this independence.

At Fox Vein and Vascular, we emphasize early and accurate diagnosis to prevent the progression of the disease. Waiting until you have a non-healing wound is waiting too long. Our in-office vascular lab Manhattan provides a comfortable and efficient setting for a comprehensive circulatory assessment.

1. Ankle-Brachial Index (ABI): This simple, painless test is the first step in screening. It compares blood pressure in the arms and ankles to detect blockages.
2. Duplex Ultrasound: This non-invasive imaging technique uses sound waves to create a real-time map of your arteries. Dr. Fox vascular specialist can see exactly where blockages are located and how severe they are, allowing for precise treatment planning. More information about our patient-centered approach is available here.

Modern, Minimally Invasive Treatments for a Mature Population

Decades ago, the primary treatment for severe PAD was major bypass surgery—a procedure with significant risks and a long recovery period, especially for older patients. Today, the landscape has changed dramatically. Dr. Fox knee pain treatment and PAD interventions focus on minimally invasive techniques that are safer and have much quicker recovery times.

These procedures are performed through a tiny needle stick, often in an outpatient setting, making them ideal for older adults who may have other health conditions.

• Angioplasty for PAD: A small balloon is inflated inside the blocked artery to widen it.
• Atherectomy Procedure: A specialized device physically removes the plaque from the artery wall. This is particularly effective for the hard, calcified plaque often seen in older patients.
• Stenting for PAD: A tiny metal mesh tube is placed inside the artery to act as a scaffold, keeping it open.

These advanced minimally invasive vascular procedures Manhattan residents trust can immediately restore blood flow, relieving pain and providing the oxygen needed to heal wounds. The goal is always amputation prevention and the restoration of a patient’s active lifestyle. We are proud to serve patients from across the region, including the 5 Boroughs, Nassau, Suffolk, South Western Ct., and North East NJ.

It’s also worth noting how vascular expertise is evolving. For instance, Genicular Artery Embolization (GAE) is a new procedure offering non-surgical knee pain relief for knee osteoarthritis—another condition common in older adults. The GAE procedure involves blocking tiny arteries causing inflammation, demonstrating the innovative ways vascular health is being addressed.

Take Control of Your Vascular Health After 60

Aging may be inevitable, but living with the debilitating pain of PAD is not. By understanding the risks and being proactive about your health, you can protect your mobility for years to come.

• Don’t ignore symptoms: Report any new or worsening leg pain, fatigue, numbness, or coldness to your doctor.
• Manage your risk factors: Work with your healthcare team to control your blood pressure, cholesterol, and blood sugar. If you smoke, quitting is the most impactful thing you can do.
• Stay active: A regular walking program, done to the point of pain and then resting, can help your body build new blood vessels (collaterals) that bypass blockages.
• Seek expert care: If you suspect you have PAD, consult a vascular specialist. Early intervention leads to the best outcomes.

Do not let PAD rob you of your independence. Leg pain that limits your life is not a normal part of getting older. It’s a sign that your body needs help.

Schedule a comprehensive vascular evaluation at Fox Vein and Vascular and take the first step toward pain-free mobility.

Fox Vein and Vascular – Manhattan, NY
📞 (212) 362-3470
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📍 1041 Third Avenue, New York, NY 10065