Does PVD always get worse with age? 

Peripheral vascular disease (PVD) is a progressive condition, meaning it naturally tends to advance over time as the body ages. Because the primary cause is the gradual accumulation of plaque in the blood vessels, the risk and severity often increase with each passing decade. However, the speed at which it worsens is not the same for everyone. With proactive clinical management and lifestyle changes, the progression of PVD can be significantly slowed or even stabilised. In this guide, you will learn about the relationship between ageing and vascular health, the factors that accelerate PVD, and how to maintain healthy circulation as you get older. 

What We’ll Discuss in This Article 

• The natural progression of vascular ageing and its impact on PVD 

• Statistical data on PVD prevalence across different age groups in the UK 

• Why age is considered a primary non-modifiable risk factor 

• Lifestyle choices that can halt or slow the worsening of symptoms 

• The role of clinical interventions like statins in stabilising plaque 

• A comparison of PVD outcomes in managed versus unmanaged cases 

• Guidance on identifying signs that the condition is advancing 

While PVD is a progressive disease, it does not have to get worse at a rapid or debilitating rate. Ageing naturally involves the stiffening of blood vessels (arteriosclerosis) and the continued buildup of plaque (atherosclerosis), but these processes are highly influenced by your daily habits and medical care. If left unmanaged, the narrowing of the arteries will likely increase, leading to shorter walking distances and a higher risk of complications. However, data shows that individuals who strictly manage their blood pressure, cholesterol, and physical activity can often maintain a stable level of health for many years. 

In the UK, it is estimated that PVD affects about 20% of people over the age of 60. Clinical research indicates that while the physical narrowing of the vessels might continue slowly with age, the functional impact how much pain you feel and how far you can walk can be improved through ‘collateral circulation’. This is when the body develops small new blood vessels to bypass older, narrowed ones. Therefore, while the underlying disease is linked to age, your quality of life and symptom severity are not entirely determined by the date on your birth certificate. 

What are the symptoms of advancing PVD? 

As PVD gets worse with age, the most common symptom is a decrease in ‘claudication distance’ the distance you can walk before leg pain forces you to stop. You may also notice that the pain takes longer to subside when you rest. Other signs of progression include skin that becomes thinner, more fragile, or develops a darker, reddish-brown discolouration. In advanced stages, you might experience ‘rest pain’, which is a persistent ache in the feet or toes that is often worse at night when the legs are elevated. 

Other physical signs that the condition is advancing include wounds or sores on the feet that take a very long time to heal or do not heal at all. You might also notice that the muscles in your legs appear smaller (muscle atrophy) due to the chronic lack of oxygen and nutrients. If you find that your feet are consistently cold or if you develop a sore that turns black, these are signs of critical limb ischaemia, which requires urgent clinical attention. Regular monitoring of your walking distance and foot health is the best way to track if the condition is progressing. 

What are the risk factors that speed up PVD as we age? 

The factors that cause PVD to worsen most quickly as we age include continued smoking, unmanaged diabetes, and persistent high blood pressure. Smoking is particularly harmful because it causes immediate damage to the lining of the blood vessels and makes the blood more likely to clot. In older adults, the combination of multiple risk factors such as high cholesterol and a sedentary lifestyle creates a ‘compounding effect’ that accelerates the hardening of the arteries. 

Risk Factor	Impact on Age-Related Progression
Active Smoking	The single fastest way to worsen PVD symptoms
Uncontrolled Diabetes	Damages small vessels and slows wound healing
High Blood Pressure	Places constant stress on already stiffened arteries
High LDL Cholesterol	Provides the material for new plaque to form
Physical Inactivity	Prevents the growth of healthy bypass (collateral) vessels

Causes of Worsening Circulation in Older Age 

The fundamental cause of worsening PVD is the ongoing process of atherosclerosis. As we age, our vessels lose their elasticity, making it easier for cholesterol and calcium to stick to the artery walls. Another cause of worsening symptoms in older age is the development of ‘multi-level’ disease, where blockages begin to form in multiple parts of the leg, such as both the thigh and the calf, rather than just in one isolated spot. 

In some cases, the condition worsens because of a ‘secondary’ event, such as a small blood clot forming on an existing area of plaque. Additionally, as people age, they may develop other conditions like heart failure or kidney disease, which can reduce the overall efficiency of the circulatory system. This makes the existing PVD feel more severe because the heart is less able to pump blood through the narrowed peripheral vessels. Understanding these interconnected causes is a key part of the comprehensive care provided by NHS vascular teams. 

Triggers for Rapid Progression 

Triggers that can cause PVD to decline rapidly in older age include sudden changes in medication, such as stopping statins or antiplatelets without medical advice. Dehydration is another common trigger in the elderly that can make the blood more viscous and harder to pump. Environmental triggers like cold winters can also cause prolonged vessel constriction, which may lead to a permanent worsening of symptoms if the circulation is already very poor. 

Lifestyle triggers, such as becoming bedbound due to another illness or surgery, can lead to a rapid loss of circulatory efficiency. Without the ‘muscle pump’ action of walking, blood can pool in the legs, increasing the risk of both arterial and venous complications. In the UK, healthcare professionals emphasise the importance of ‘walking through the pain’ (within safe limits) to trigger the body’s natural repair mechanisms and prevent the condition from worsening during periods of inactivity. 

Differentiation: Normal Ageing vs Pathological PVD 

It is important to distinguish between the normal changes that happen to everyone’s blood vessels as they age and the specific changes caused by peripheral vascular disease. 

Feature	Normal Vascular Ageing	Pathological PVD (Worsening)
Vessel Wall	Mild stiffening (Arteriosclerosis)	Plaque buildup (Atherosclerosis)
Blood Flow	Generally adequate for daily tasks	Significantly restricted to the limbs
Pain	No specific leg pain with walking	Cramping/aching (Claudication)
Skin Changes	Slight thinning or dryness	Shiny skin, hair loss, ulcers
Outcome	Usually no loss of mobility	Can lead to severe disability if ignored
Management	General healthy lifestyle	Medical intervention and specific exercise

Conclusion 

PVD does tend to progress as you get older because it is a chronic condition linked to the ageing of the circulatory system. However, it does not always have to get worse to the point of limiting your life. By managing risk factors like smoking and high blood pressure, and by staying physically active, you can slow the progression and maintain healthy circulation. If you experience severe, sudden, or worsening symptoms, call 999 immediately. 

Authority Snapshot 

This article was reviewed by Dr. Stefan Petrov, a UK-trained physician with an MBBS and extensive experience in general medicine and emergency care. Dr. Petrov has worked within the NHS to manage long-term vascular conditions in older populations, focusing on preventative care and patient education. This information is based on the current standards from NICE and the NHS to ensure accurate and safe guidance for the public.