American Heart Month: The Connection Between Heart Disease and Chronic Wounds

February is American Heart Month, highlighting the risks of heart disease and steps to stay heart-healthy.

You may hear people emphasize the need for a heart-healthy lifestyle, regular blood pressure checks, better eating, and exercise.

Preventing heart disease is essential not only because it is the top cause of death in the United States, but also because it profoundly affects the body’s ability to heal wounds.

Patients with cardiovascular conditions like coronary artery disease, PAD, or other circulatory issues may find that a small cut or sore becomes a chronic wound. Having both heart disease and diabetes raises this risk even more.

During Heart Month, Innovative Wound Care aims to spotlight the often-overlooked yet significant link between heart disease and impaired wound healing.

Summary

Delayed wound healing signals broader cardiovascular dysfunction, underscoring the need for lifestyle changes, careful monitoring, and coordinated care to manage heart health and chronic wounds. Heart disease impairs circulation, oxygen delivery, and immune function, while diabetes often further complicates healing.

How Heart Disease Disrupts the Wound Healing Process

Wound healing is a complex, four-stage process that requires the right environment to heal and prevent infection. When the cardiovascular system is compromised, it creates circulation bottlenecks, making it difficult for essential nutrients and repair cells to reach the wound site, which directly affects chronic wound healing.

The primary ways heart disease interferes with wound healing include:

Reduced Blood Flow (Ischemia)

One of the most direct ways heart disease affects wound healing is by reducing blood flow.

Conditions like peripheral arterial disease (PAD), in which arteries narrow and restrict circulation, starve tissues of oxygen-rich blood and essential nutrients vital for tissue repair.

This process, known as ischemia, slows or completely stalls the body’s natural healing mechanisms, making wounds more susceptible to infection and other serious complications.

Impaired Oxygen Delivery

Oxygen is essential for the cellular repair phase of the wound healing process.

Cells responsible for repair and fighting infection need a steady supply of oxygen to regenerate and defend effectively.

When cardiovascular health is compromised, the amount of oxygen delivered to the wound site decreases, which can delay healing.

Chronic Inflammation

Heart disease, particularly when it leads to conditions like diabetes or high blood pressure, can increase the risk of inflammation. Some inflammation is needed for proper wound healing, but chronic inflammation can interfere with the body’s ability to heal itself.

This type of systemic inflammation can cause a wound to become “stuck” in the initial inflammatory phase, preventing it from progressing to the proliferation phase, where new skin and tissue actually grow.

Impaired Immune Defense That Can Lead to Infection

Heart disease impairs circulation, making it harder for the immune system to deliver white blood cells to wounds. This weakens the body’s defenses, leaving wounds more prone to infection.

Stagnant Waste Removal

The healing process generates waste, but heart failure slows venous return and lymphatic drainage, making it harder to clear debris and metabolic waste. Waste buildup stalls repair and increases infection risk.

Fluid Buildup and Pressure

Fluid buildup (edema) is common in heart conditions, especially congestive heart failure (CHF), where poor pumping causes blood and fluid to back up in tissues, often in the legs, feet, abdomen, or lungs. This increases skin pressure, reduces circulation, and can cause wounds.

What the Latest Research Says: The Skin is a Mirror to the Heart

There has long been a strong science-backed connection between chronic wounds that are slow to heal and heart disease. The inability to heal properly is a red flag that your body’s circulatory and repair systems may be compromised.

More recent studies also demonstrate that the body’s response to a simple skin wound may even predict how the heart recovers after a major cardiac event, such as a heart attack.

A 2022 study published in the American Journal of Physiology found that individuals with faster skin wound healing had better survival rates after a myocardial infarction. The study’s authors concluded that “the skin is a mirror to the heart” because common biological pathways link healing processes across these organs.

Both skin and cardiac tissue rely on the same sequence of inflammation, tissue repair, and scar formation. A delay or dysfunction in this process, whether on the skin or in the heart, signals a systemic problem.

This study further highlights that a non-healing wound is not just a surface-level issue; it is often a visible sign of underlying systemic health problems, including cardiovascular disease.

What Types Of Wounds Are Most Common In People With Heart Disease?

A chronic wound is one that fails to heal within a typical timeframe, typically defined as four weeks or longer. While any wound can become chronic, certain wounds are more prevalent in those with cardiovascular conditions.

Common chronic wounds linked to heart disease include:

Arterial Ulcers: Painful wounds that occur due to inadequate blood flow caused by blocked arteries. They are most often found on the feet, ankles, and toes.

Venous Ulcers: These occur when damaged veins in the legs prevent blood from flowing back to the heart, leading to pooling of blood. The increased pressure and swelling can lead to open sores, typically around the ankles.

Pressure Injuries: If you have a heart condition that limits your mobility, leaving you bedridden or obese, you are at a higher risk of pressure injuries, which form when prolonged pressure on the skin cuts off blood supply.

Diabetic Ulcers: Diabetes often accompanies cardiovascular disease, and is a major risk factor for developing chronic wounds, especially in the feet and legs.

A Dangerous Duo: Diabetes and Heart Disease

Diabetes and heart disease often coexist, and both can complicate the wound healing process.

High blood sugar damages vessels, causing poor circulation and weakened immunity, both major risks for chronic wounds in diabetes. Combined with the effects of heart disease (poor circulation, low oxygen delivery, fluid buildup, and inflammation), wound healing becomes even more challenging.

If you have diabetes, especially if you have a diabetic ulcer and haven’t already, it is important to be screened for heart disease. Research shows that the presence of a diabetic foot ulcer (DFU) is a strong indicator of an underlying cardiovascular problem.

A 2024 meta-analysis published in Endocrine analyzed over 8,600 patients and found that 44.7% of patients with a DFU also have ischemic heart disease, 25.1% suffer from congestive heart failure, and have a 2.59 times greater risk of cardiovascular-related death compared to diabetics without an ulcer.

How to Manage Chronic Wounds with Cardiovascular Disease

For those living with heart disease, managing chronic wounds can be challenging, but it’s not impossible. Improving circulation, regular skin checks, protecting skin health, making heart-healthy lifestyle changes, managing diabetes, and coordinating care across specialties can all significantly improve healing outcomes.

Promote Healthy Circulation: Anything you can do to improve blood flow supports the delivery of oxygen and nutrients to healing tissues. Exercise, lifestyle changes, and doctor-prescribed medications that help manage cardiovascular or vascular conditions are crucial. Elevating your feet and compression stockings can also help improve circulation in the lower legs, which may be especially beneficial for individuals with venous disease.
Monitor Wounds Closely: Check your skin daily for new sores or changes in existing wounds, particularly for signs of infection, such as increased redness, warmth, drainage, or a foul odor. Early intervention is key to preventing further complications.
Support Skin Health: Keeping the skin clean, moisturized, and protected is essential in wound care. If you have a slow-healing wound, following a skin care routine designed to support wound healing can help protect surrounding skin, reduce irritation, and support the healing process.
Adopt a Heart-Healthy Lifestyle: Eating nutrients that promote wound healing and adopting a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins can improve circulation and promote overall skin health. Quitting smoking is also vital, as nicotine constricts blood vessels and chokes off blood supply to your tissues. Maintaining a healthy weight further helps reduce the risk of complications related to both heart disease and chronic wounds.
Control Blood Sugar Levels: If you have diabetes and heart disease, managing blood sugar levels is vital. Stable glucose levels support both cardiovascular health and enhance the body’s ability to heal wounds.
Seek Multidisciplinary Specialized Care: In many cases, people with heart disease benefit from working with multiple medical professionals, including primary care providers, cardiologists, wound care specialists, and diabetes educators. A multidisciplinary approach can help address both the underlying health conditions and the wound itself.

Frequently Asked Questions (FAQ)

Can improving my heart health help my existing wounds heal faster?

Yes. Improving heart health can enhance circulation and oxygen delivery, both of which are essential for chronic wound healing and for slow-healing wounds. Working with your doctor to better manage your heart condition can improve circulation throughout your body. Lifestyle changes like adopting a heart-healthy diet, quitting smoking, and engaging in approved physical activity can significantly boost your body’s ability to heal.

Can heart failure cause chronic leg wounds?

Yes. Heart failure often leads to fluid retention and swelling in the legs (edema). This increased pressure on the skin, combined with poor circulation, can easily lead to non-healing wounds.

What are the warning signs that a wound isn’t healing properly?

A wound may not be healing properly if it shows little to no reduction in size after two to four weeks, has excessive drainage, increased redness or warmth, develops a foul odor, or becomes more painful. These are signs that you should seek specialized medical care immediately.

Will a chronic wound ever heal?

Yes, with proper care, many chronic wounds can heal with a targeted, multidisciplinary approach that addresses the underlying cause and, if necessary, wound care treatments that promote effective healing.

How can you tell if a chronic wound is healing?

A chronic wound is healing if it shows consistent improvements over weeks. Positive signs include reduced size, less pain, minimal clear drainage, skin edges closing, and the appearance of new pink or reddish tissue.

Take Action for Your Heart and Health this Heart Month

American Heart Month in February serves as an important reminder to take charge of your cardiovascular health. For those with existing heart and vascular conditions, taking steps to improve circulation and overall well-being can significantly reduce the risk of wound-related complications.

By raising awareness of the connections between heart disease and chronic wounds, we hope to encourage individuals to take charge of their health, reduce risks, and ultimately improve quality of life.

Whether through lifestyle changes, medical interventions, or simply staying informed, there are many ways to protect your heart, which also supports circulation, tissue health, and the body’s ability to heal.

This February, take a little extra time to check in with your heart (and your wounds). Your health is worth it!

For those in Flint, Michigan, and the surrounding areas living with heart disease and a non-healing wound, help is available. If you are struggling with a wound that won’t heal, don’t wait. Contact Innovative Wound Care Specialists today to schedule a consultation.

Medical Disclaimer: This content is for informational and educational purposes only and is not intended as medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or cardiovascular risk.