A Systematic Review of Rural Cardiovascular Disease Clinical Trials



Cardiovascular health, Systematic Review, Rural Health


Background: Rural cardiovascular outcomes research is scant, and attention must be focused on evidenced-based interventions to better inform policy for population-based care and distribution of rural healthcare resources.

Objective: This review explores the current state of clinical trial cardiovascular literature with samples that included rural women and men. 

Methods: A systematic review was conducted of cardiovascular disease research from 2010 through 2022. The search included PubMed, Cumulative Index of Nursing and Allied Health Literature through EbscoHost databases, as well as a hand search of rural specific journals. Search terms included cardiovascular disease, heart disease, and rural. The final review included 25 cardiovascular research articles.

Results: Synthesis by modifiable risk factors, cardiovascular outcomes, general findings, and social determinates of health are presented. Anthropomorphic measures and biomarkers were provided in 11 studies. Data on hospitalizations, admissions, emergency department use, length of stay, and hospital protocols were analyzed in nine studies. Mortality rates were analyzed in six of the 25 studies. Modifiable risk factors synthesis indicates mixed findings in the research. A previously unreported finding was that all but five articles reported sample recruitment entirely from a rural place.

Conclusions: Research involving rural communities is essential to understanding the unique characteristics of rural populations that influence their cardiovascular health and mortality risk. Exploration of the social determinants of health that increase cardiovascular disease risk is necessary to inform policy driving public health interventions that aim to reduce health disparities in rural populations. The findings update the evidence-base available for practice.

Keywords: cardiovascular disease, rural health, systematic review

DOI:  https://doi.org/10.14574/ojrnhc.v23i2.747 


Author Biographies

  • Stacey A. Marye, Ph.D., RN, , University of North Carolina at Greensboro

    Assistant Professor, School of Nursing,

  • Allison K. Roma, FNP-C, RN, Ph.D. Student, Binghamton University

    Ph.D. Student and Graduate Assistant to the Florence B. Decker Endowed Chair in Rural Nursing, Decker College of Nursing and Health Sciences


  • Pamela Stewart Fahs, RN, PhD, FAAN, Binghamton University

    Associate Dean, Professor, and Florence B. Decker Endowed Chair in Rural Nursing, Decker College of Nursing and Health Sciences,