This registry study evaluated echogenicity of carotid-femoral plaques in asymptomatic subjects with increased oxidative stress and risk factors (mild hypertension, hypercholesterolemia). Supplementation with the combination Pycnogenol-CA (centella asiatica) on the echogenicity of plaques was assessed at 6 months (79 subjects). A standard management (SM) plan was used in all subjects (control of risk factors, lifestyle changes); 36 subjects used the supplements +SM; 43 SM only. The groups were comparable. High-resolution ultrasound evaluated echogenicity and plaque structure. Pycnogenol (150 mg/day) and CA (Centellicum, 450 mg/day) were used. At 6 months, cholesterol was reduced (p < 0.05) in both groups (difference between groups not significant). At 6 months, plasma free radicals were decreased with the supplements (17.64%; p < 0.05; vs <2% in controls). The plaque stability index increased from 11.22;2.3 to 22.4;1.1 (p < 0.05) with the supplements; no significant changes were seen in controls. Plaque echogenicity (% of "whiter" component in images) increased with supplementation from 16.7;1.7% to 34.2;2% (p < 0.05); no variations were observed in controls. The maximum plaque height decreased (p < 0.05) with the supplements. No significant variations were observed in controls. Plaque length was decreased (p < 0.05) in the supplement group with no changes in controls. The number of plaques (carotid, femoral bifurcations) decreased with supplementation; no significant changes were observed in controls. No adverse events, tolerability problems, or variations in routine blood tests were recorded. The combination Pycnogenol-CA appears to improve echogenicity and stability of complex plaques in 6 months.