The study by researchers at Women's College Hospital in Ontario and the Institute for Clinical Evaluative Sciences (ICES) is the first to examine outpatient quality of care between urban and rural communities.
It counters the existing research, which suggested gaps in care for those living in rural areas.
"Research has long suggested people with heart disease in rural areas are at a disadvantage when it comes to access to health care and longevity," said Dr Sacha Bhatia, lead author of the study and a cardiologist at Women's College Hospital.
"Our study shows once a patient leaves the hospital their overall health outcomes are similar regardless of where they live," said Bhatia.
The study examined the records of more than 38,000 people with chronic ischemic heart disease living in either urban or rural areas.
They found, in comparison to their urban counterparts, those in rural areas had fewer specialist visits and visited hospital emergency departments more frequently for care.
They were prescribed statins less often, were tested less frequently for cholesterol and blood sugar levels and experienced a similar risk of hospitalisation and death.
The researchers said while those living in rural areas access their care differently, it did not result in poor health outcomes.
"From our study, we know that people with heart disease in rural areas tend to rely heavily on emergency departments for their care because of a lack of outpatient access to family doctors and specialists," said Bhatia.
"Yet, despite an increase in emergency department admissions in rural areas, we didn't see worse health outcomes for these individuals," Bhatia said.
The study was published in the journal Circulation: Cardiovascular Quality and Outcomes.