SUPPLEMENTS

Boost HDL.

HDL isn't called the good cholesterol for nothing. If HDL isn't present to transport harmful LDL cholesterol to the liver for elimination, the LDL will stick to the endothelium and increase the risk for blood-clot formation. Goodman says one recent study found that boosting HDL by a mere 1 percent will cut a woman's cardiovascular disease risk by 3 percent and a man's by 2 percent. He recommends taking supplements that have been proven to raise HDL, including fish oil, niacin, coenzyme Q10, grapeseed extract, and policosanol.

Combine fish oil and exercise.

Getting regular aerobic exercise and taking fish oil may be more effective at cutting cardiovascular disease risk than either alone, according to a 2007 study published in the American Journal of Clinical Nutrition. Goodman recommends taking 3 grams of fish oil daily and adding one hour of exercise (during which your heart rate is elevated) four to five times a week for maximum vascular benefits.

LIFESTYLE

Exercise regularly.

Do it even if you're thin. Lounging on the couch instead of moving your body is deadly for the vascular system — whether you're overweight or not. “Just because you're not fat doesn't mean you don't have to exercise,” Goodman says. Two studies published in the Journal of the American Medical Association found that being inactive was a stronger predictor of coronary heart disease, heart attack, and stroke in women than being obese. Another study found that women who exercised regularly but were obese had almost twice the risk of death compared with women who were both active and lean. What's the takeaway? A sedentary lifestyle and excess pounds are a double whammy for the vascular system.

Breathe fresh air.

Air pollution is just as bad for your vascular system as it is for your lungs. Researchers determined that breathing in diesel exhaust fumes reduces blood flow and interferes with the body's natural ability to break up blood clots. A 2007 Clean Air Task Force study found that the pollution levels inside cars, buses, and trains are four to eight times higher than in the outdoor air in many urban areas. So if you live in a large metropolis, do your blood vessels a favor and walk to work. When exercising, choose a hike, ride, or trail run away from traffic.

Look inside

Monitoring blood pressure and cholesterol is important, but it isn't the only way to assess vascular disease risk. These noninvasive tests can offer a glimpse inside the vascular system.

PLAC test

Measures vascular inflammation and helps determine if you're at risk for stroke or heart attack years before the event may occur.

Carotid intima-media thickness (CIMT) test

Detects early atherosclerosis (thickening and hardening of the arteries) by using an ultrasound to measure the thickness of the carotid arteries in the neck.

Source: Dennis Goodman, MD, FACC.