Purpose: Qualitatively examine how community health clinics delivered cardiovascular disease (CVD) preventive care during COVID-19 using virtual care and related adaptations. Methods: Semi-structured interviews were conducted in 2021-2022 with nine clinician leaders from four clinics across the country that share an electronic health record. Interviews covered: (1) the pandemic's impact on preventive care delivery, (2) the adaptation and role of virtual care, and (3) management of CVD risk in this context. Collected data were analyzed using a thematic analysis approach. Results: Staff reported substantial pros and cons to virtual care for CVD risk management. It was seen as useful for general check-ins with patients. However, without current laboratory results and vital measurements, providers found it challenging to assess patient CVD risk and direct care accordingly. Conclusion: Findings add to the evolving evidence base that the necessary pivot to virtual care during the pandemic spurred innovations but also created limitations and delays in delivering appropriate preventive care.