artery in older adults

Overview

Arteries are the blood vessels that carry oxygen-rich blood from your heart to the rest of your body. As you age, the walls of these arteries can naturally become stiffer and narrower. A common problem is the build-up of fatty deposits inside the artery walls, called atherosclerosis. This can reduce blood flow to vital organs and limbs, and may lead to symptoms like leg pain, chest discomfort, or more serious problems such as heart attack or stroke.

Yes. Artery changes are very common with ageing. Most people over 60 have some degree of arterial stiffness or plaque build-up, even if they don't notice any symptoms.

Artery problems mainly affect adults aged 50 and older. Men are often affected earlier than women, but risk increases for everyone after women go through menopause. People with diabetes, high blood pressure, high cholesterol, or a history of smoking have a higher chance of developing artery disease.

Symptoms

Common symptoms

• Chest pain or discomfort (sometimes called angina) – often a feeling of heaviness, tightness, or pressure during activity
• Shortness of breath, especially with mild exertion
• Pain, cramping, or heaviness in the legs when walking that goes away after a few minutes of rest (a condition called claudication)
• Dizziness or feeling light-headed
• Unexplained fatigue or reduced energy for daily activities

Symptoms in older adults

• Symptoms can be subtler in older adults. You might notice you can't walk as far as you used to, or that one leg feels cooler than the other.
• Poor wound healing – especially on the feet or legs – can be a sign of reduced blood flow.
• Memory problems or difficulty concentrating, which can be related to reduced blood flow to the brain.
• Erectile dysfunction in men.
• Feeling unusually tired after normal activities.

Causes

Main causes

• Age-related stiffness: over time, the artery walls become thicker and less flexible.
• Atherosclerosis: a slow build-up of fatty deposits (plaque) inside the artery walls, which can narrow the artery and limit blood flow.
• High blood pressure: extra pressure damages the inner surface of the arteries, making them more likely to develop plaque.
• Chronic inflammation: conditions like diabetes or autoimmune diseases can injure artery walls over time.

Risk factors

• Smoking or being exposed to second-hand smoke
• High cholesterol or high triglycerides
• High blood pressure
• Diabetes or prediabetes
• Being overweight or having obesity
• Physical inactivity
• Family history of early heart disease or stroke
• Unhealthy diet – high in salt, sugar, and saturated or trans fats
• Long-term stress

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above, call your local emergency number (e.g., 911, 999, 112) immediately.
• If you have new or worsening chest pain, shortness of breath, or leg pain that won't settle, contact your doctor or go to an emergency department the same day.

Book a routine appointment if:

• Make an appointment to discuss your risk if you smoke, have diabetes, high blood pressure, high cholesterol, or a family history of heart disease.
• If walking distance is becoming shorter due to leg discomfort, or you notice changes in your feet (coldness, pale colour, poor healing), see your doctor.
• Even if you feel well, a routine check-up every 1–2 years can help catch early artery problems.

Diagnosis

Your doctor will start by asking about your symptoms, medical history, and lifestyle. They will listen to your heart, check your pulse in your arms, legs, and feet, and measure your blood pressure. Based on that, they may recommend simple tests to look at blood flow and the health of your arteries.

Tests that may be done

• Ankle-brachial index (ABI): a simple test that compares blood pressure in your ankle with blood pressure in your arm. It helps detect reduced blood flow to the legs.
• Blood tests to check cholesterol, blood sugar, and kidney function.
• Ultrasound of the arteries (duplex scan): uses sound waves to assess blood flow and find any narrowings.
• Electrocardiogram (ECG) to check the heart's rhythm and detect prior heart damage.
• More advanced imaging, like a CT or MRI scan, if your doctor needs a closer look at the blood vessels.

What to expect at your appointment

These tests are usually painless and are done in a clinic, GP surgery, or hospital outpatient department. Your doctor will explain the results and what they mean for you. If a problem is found, you will be offered a treatment plan that may include lifestyle changes, medication, and in some cases a procedure to improve blood flow.

Treatment

Treatment for artery disease aims to improve blood flow, relieve symptoms, and reduce the risk of serious problems like heart attack or stroke. Your healthcare team will work with you to create a plan that fits your needs. This usually involves making healthy lifestyle changes and, if necessary, taking medicines to control blood pressure, cholesterol, or blood sugar. In some cases, a small procedure or surgery may be recommended to restore blood flow.

Self-care at home

• If you smoke, quitting is the single most important step you can take for your arteries.
• Try to be physically active every day – even a short walk can help improve circulation.
• Eat a balanced diet low in salt, sugar, and unhealthy fats, and rich in vegetables, fruits, and whole grains.
• Manage stress through relaxation techniques, breathing exercises, or activities you enjoy.
• If you have diabetes, keep your blood sugar in a healthy range.
• Check your feet daily for any cuts, blisters, or sores – especially if you have symptoms in your legs.

Medical treatments

Your doctor may prescribe medicines to help lower blood pressure, reduce cholesterol levels, prevent blood clots, or widen the blood vessels. Always take them exactly as prescribed and do not stop without talking to your doctor. You may also be offered a supervised exercise programme, such as cardiac rehabilitation, to improve your symptoms safely.

When is surgery considered?

If an artery is severely narrowed or blocked, you may be offered a procedure to restore blood flow. This could involve inserting a tiny mesh tube called a stent to keep the artery open, or bypass surgery to replace the blocked section with a healthy blood vessel from another part of your body. Your healthcare team will explain the options and help you decide what is best for you.

Living with this condition

Many people with artery disease live full, active lives. The key is to follow your treatment plan, stay as active as you can, and keep your follow-up appointments. If you have leg symptoms, take rest breaks when walking, keep your feet clean and moisturized, and avoid walking in very cold weather without warm footwear.

Lifestyle tips

• Walk to a comfortable point, rest, then walk a little more each day – gradually increase your distance.
• When sitting, elevate your legs and avoid crossing them for long periods.
• Wear comfortable, well-fitting shoes and thick socks to protect your feet.
• Keep warm in cold weather to help your circulation.
• Keep all your healthcare appointments and take your medicines as prescribed.

Diet and exercise

Eat a heart-healthy diet that includes plenty of vegetables, fruits, whole grains, beans, fish, and healthy fats like olive oil or nuts. Limit salty snacks, sugary drinks, and processed foods. For exercise, aim for at least 30 minutes of moderate activity on most days – brisk walking, cycling, or swimming are all excellent choices. Always talk to your doctor before starting a new exercise programme.

Mental health and emotional wellbeing

Living with a long-term condition can sometimes cause worry, stress, or low mood. It's completely normal to have these feelings. Sharing your concerns with your doctor, family, or friends can help. If you feel down for more than two weeks, or find that worry is taking over your life, speak to a healthcare professional – there are effective treatments for anxiety and depression.

Prevention

While you can't stop ageing, you can slow down or even prevent many artery problems. The same healthy habits that treat artery disease also help prevent it: do not smoke, stay physically active, eat a balanced diet, drink alcohol in moderation, and work with your doctor to keep blood pressure, cholesterol, and blood sugar in a healthy range.

Vaccines

Keep up to date with recommended vaccinations, such as the flu and COVID-19 vaccines. Respiratory infections can put extra strain on your heart and blood vessels, so staying well can help protect your arteries.

Screening programmes

Your doctor may recommend regular blood pressure checks and cholesterol blood tests, especially if you have risk factors like diabetes, high blood pressure, or a family history of heart disease. Early detection gives you a better chance of preventing complications.

Complications

If left untreated

• Heart attack
• Stroke
• Severe peripheral artery disease, which can lead to poor wound healing, gangrene, and in rare cases limb amputation
• Aneurysm – a bulging, weakened area of an artery wall that can be life-threatening if it bursts
• Chronic kidney disease due to reduced blood flow to the kidneys

Long-term outlook

With good medical care and a commitment to healthy habits, most people with artery disease can live long, full, and active lives. Treatment has improved hugely over recent years, and the risk of serious complications can be dramatically reduced. Your healthcare team is there to help you at every stage – so reach out, stay engaged, and know that positive steps make a real difference.

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