Cardiovascular Competency in Rural Primary Care: A Nurse Practitioner Workforce Priority

Rural Americans bear a disproportionate cardiovascular burden while facing limited access to cardiology services. This brief report proposes a workforce and practice framework for rural primary care nurse practitioners. The solution to rural cardiology scarcity is not unsupported specialty-level practice, but investment in nurse practitioner preparation and practice infrastructure. Grounded in established competencies, the framework distinguishes routine cardiovascular care, supported primary care requiring preparation and consultation, and specialty or escalated care. Recommendations emphasize curricular integration, supervised clinical experience, competency validation, health system safeguards, and consultation networks. Rural scarcity should strengthen primary care capacity, not lower standards or blur clinical boundaries.