A 69-year-old woman is evaluated for follow-up 3 months after a non–ST-elevation myocardial infarction. She was assessed to be at low risk, and she was treated medically. Since the acute event, the patient has done well. She has no chest discomfort or shortness of breath. She has hypercholesterolemia and hypertension. Medications are lisinopril, metoprolol, atorvastatin, aspirin, and clopidogrel. She has modified her diet and has begun performing physical activity 5 days a week.
On physical examination, the patient is afebrile, blood pressure is 125/80 mm Hg, pulse rate is 60/min, and respiration rate is 12/min. BMI is 26. A normal carotid upstroke without carotid bruits is noted, jugular venous pulsations are normal, and normal S1 and S2 heart sounds are heard without murmurs. Lung fields are clear, distal pulses are normal, and no peripheral edema is present.
Laboratory studies show adherence to her lipid therapy and are otherwise normal.
Which of the following will offer this patient the greatest reduction in her risk of future cardiovascular events?