When a water pipe clogs in your house, every room can be affected. The same goes for the pipes in your body — the veins, arteries, and capillaries that make up the vascular system and supply your organs with blood. If these blood vessels are damaged by high blood pressure, diabetes, or plaque buildup, a whole cascade of problems can ensue, including kidney failure, dementia, peripheral artery disease, erectile dysfunction, heart attack, and stroke. Keeping all of your body's blood vessels free flowing is vital because “it is very rare for only one part of the vascular tree to be affected by disease,” says Dennis Goodman, MD, FACC, senior cardiologist at Scripps Center for Integrative Medicine in La Jolla, California. In other words, if the vessels that carry blood to the feet, legs, arms, stomach, and kidneys aren't healthy, it's likely your heart and carotid arteries, and the pipes that supply blood to the brain, will be affected too.

But vascular disease is preventable and in some cases reversible when you take healthy steps — even if heart disease, stroke, or other vascular problems run in your immediate family, Goodman says. Here's how to keep the clogs out and lessen your chances of needing pharmaceutical drugs.

NUTRITION

The lining of your blood vessels, called the endothelium, provides a Teflon-like coating that helps blood flow smoothly through veins, arteries, and capillaries, says Ralph Felder, MD, PhD, a cardiologist at Banner Good Samaritan Medical Center in Phoenix. High blood pressure, high cholesterol, diabetes, and inflammation all can create nicks in the endothelium. These encourage a buildup of arterial plaque, and can lead to decreased blood flow to the heart, brain, and other organs. What you eat — and don't eat — has a monumental impact on the health of this vital blood-vessel lining. As Felder writes in The Bonus Years Diet (Putnam Adult, 2007), a breakthrough study found that when consumed together and in the specific quantities detailed below, the following foods actually act like a powerful drug and reduce the risk of cardiovascular disease by 76 percent and add 6.4 years to a man's life and 4.6 years to a woman's life — all by protecting the endothelium.

Cook with garlic.

Flavor your meals with one garlic clove (cooked or raw) daily and your chance of developing cardiovascular disease drops by 25 percent. That's because garlic inhibits the cholesterol production in the liver, much the way statin drugs do. Garlic specifically lowers low-density lipoprotein (LDL) and may help to usher this bad form of cholesterol out of the body.

Drink red wine.

Sipping 5 ounces of red wine daily lowers LDL, raises the good high-density lipoprotein (HDL) cholesterol, and prevents LDL oxidation and the formation of dangerous blood clots. Added together, the benefits of red wine's protective antioxidants slash cardiovascular disease risk by 32 percent. (Women, take note: Alcohol, including wine, has been linked to an increased risk of breast cancer. However, research shows that up to 5 ounces of red wine daily is safe, Felder says. Because it increases estrogen levels, “more than that can lead to health problems for women.”)

Eat fruits and vegetables.

Antioxidant- and fiber-rich fruits and vegetables lower blood pressure, and “the lower the blood pressure, the better the endothelium is able to dilate the arteries to keep blood flowing smoothly,” Felder says. Eating 4 cups of fruits and veggies daily lowers your cardiovascular disease risk by 21 percent. Different types of produce offer different benefits — so aim for variety to receive the full spectrum of antioxidants and phytochemicals, the special chemicals found in plants that reduce inflammation and protect against disease.

Pass on the salt

Cutting salt consumption lowers blood pressure — which itself is vital for a healthy vascular system. But a recent study published in the British Medical Journal found that slashing sodium also reduces the risk of stroke and other cardiovascular disease by 25 percent.
— C.M.

Favor cold-water fish.

Want to shrink your risk of heart attack and stroke by another 14 percent? Eat three 5-ounce servings (which is slightly less than the size of two standard decks of cards) of wild-caught, cold-water fish, such as salmon, mackerel, and herring, per week. The omega-3 fatty acids in these fish prevent blood clots, lower triglycerides, raise HDL, reduce inflammation, and prevent fatal heart arrhythmias (an interruption of normal heart rate).

Grab a handful of nuts.

Almonds, macadamias, and other nuts provide an almost perfect balance of protein, carbohydrates, and fats — particularly heart-protective monounsaturated fats. Nuts, on average, also contain about 170 mg potassium and 60 mg magnesium per ounce, both of which help lower blood pressure, Felder says. Add in 2 ounces of nuts daily and you'll reduce your overall cardiovascular disease risk by 12 percent.

Treat yourself to chocolate.

Packed with flavonoids (a type of antioxidant), dark chocolate reduces blood pressure, which improves endothelial function and decreases LDL oxidation. Eat 2 full ounces (with a minimum 60 percent cocoa content) daily and you'll cut your cardiovascular disease risk by 11 percent.

Next Page: Supplements and Lifestyle

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.

Coronary calcium scan

Identifies coronary disease risk, even in people who do not fit the typical high-risk profile, by measuring calcium deposits in the arteries.
— C.M.

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.