It is widely believed that process of fat deposition causing blockage [atherosclerosis] is steadily progressive and keeps on increasing with age. But it has been observed that this process is quite variable. It can rapidly increase [in few months] causing even less than 50% blockages to rupture causing heart attack if the risk factors are grossly uncontrolled. There have been several instances of rapid growth of new blockages after bypass surgery or angioplasty with recurrence of angina or heart attack.

Contrary to this, even severe blockages can remain stable or even regress to some extent if good risk factor centered is maintained through medically guided aggressive lifestyle modification called therapeutic lifestyle changes or TLC. Several studies have shown that a reversal of 3% to 8% is achievable and even this small reversed can stabilize the plaque and results in impressive 30 – 50% decrease in angina as well as risk of heart attack.