Heart disease is the number one cause of death in the United States and the second most prevalent cause of death in Canada. The 12-month trial recruited workers aged 25 to 65 years, with a current primary care physician from three Canada Post Corporation worksites (Edmonton, Toronto, and Vancouver). Participants were first screened for CVD risk using the Framingham Score then randomized to either enhanced usual care (EUC: three 1-hour biometric screening and data collection visits) or naturopathic care plus EUC (NC+EUC; the above plus an individualized mix of lifestyle counselling and nutritional and botanical medicine offered during the data collection visits plus up to four additional 30-minute visits over the year). Both groups received care in an on-site clinic from licensed naturopathic doctors and were asked to continue to see their family physician as needed for their general health care needs. Medical claims and sick leave data were also accessed. In total, 156 subjects (77 EUC, 79 NC+EUC) participated. In the NC+EUC group, cardiovascular disease event risk over the next 10 years was reduced by 3.3% and CVD mortality risk by 0.9%. While, the naturopathic intervention was more expensive, statin drugs alone cost more. The impact of naturopathic care on the NC+EUC group saw more presenteeism. This trial demonstrates that a naturopathic approach to the primary prevention of CVD has the potential to significantly reduce CVD risk for those with a wide range of baseline risk.