As we grow older, we accept chronic aches and difficulty walking as part of life. However, pain in the legs can also indicate a more serious condition: peripheral artery disease, a form of vascular disease in which the arteries become filled with a waxy substance called plaque, blocking blood flow.

Left untreated, a lingering pain can develop into a health emergency. Major arteries deliver oxygen-rich blood to all parts of the body, including the legs. When oxygen supply drops, the tissue cannot survive.

Learning more about the signs, risk factors and treatments related to this disease can help you take care of your vascular health and age well.

Question: Am I at risk for peripheral artery disease?

Answer: Plaque naturally builds up and hardens in the arteries over time, so those over 50 have a higher risk of developing peripheral artery disease. Besides aging, certain conditions and risk factors can accelerate the buildup.

Diabetes and smoking are strongly linked to peripheral artery disease, and other issues such as high blood pressure or obesity could be a factor in the condition. In Hawaii nearly 600,000 people are living with prediabetes or diabetes, and more than 300,000 residents report high blood pressure, putting them at risk of developing peripheral artery disease in the future.

Question: I’m 50 and have leg pain. Should I talk to a doctor?

Answer: If you begin to experience leg pain while walking, especially the larger muscles such as the calf, take note. While it might seem like a part of growing older, it could actually indicate that the muscle isn’t getting enough oxygen.

As the artery becomes increasingly clogged, pain develops in the foot, which hurts even when at rest. Infected sores, ulcers and even gangrene on the foot or leg are the most advanced symptoms of peripheral artery disease, and could lead to amputation.

Talk to a doctor when you first develop pain while walking. Caught early, vascular disease can be delayed with medication and lifestyle changes.

Question: I’ve been diagnosed with peripheral artery disease. What are my treatment options?

Answer: When the disease is more advanced, the artery becomes so blocked that we need to find a way to increase blood flow. Years ago invasive surgery was the only option. Now balloon angioplasties are commonplace. In this procedure a small balloon is inserted into the blood vessel through a tiny needle hole in the leg and inflated to “open” the blocked artery.

In my field of vascular surgery, we are constantly improving our research to cut down on recovery time and decrease the chance of future blockages. I had the privilege of serving as co-principal investigator on an international study that used drug-coated balloons during angioplasties. When inflated in the blood vessel, the medication coats the artery wall and stays active for many months, delaying the repeat buildup of plaque.

Two years after our study, 79 percent of our patients are reporting open arteries compared with just 50 percent in regular angioplasties. So far, two different drug-coated balloon treatments have been approved by the FDA. In the coming years patients with vascular disease will have wider access to this procedure, with quicker recovery and less pain.