Heart attacks are generally not caused by the plaque, but by the plaque's fibrous cap rupturing and suddenly blocking the vessel. To avoid the possibly immediate and fatal consequences of a lifetime of rich eating requires halting the vicious cycle of postprandial endothelial inflammation, immune cell activity and oxidative stress, permitting the fibrous cap to grow a bit stronger.
To my knowledge, only one intervention has truly superb outcomes here, and that's Dr. Caldwell Esselstyn's combination of a fat-free vegan diet (no animal products, oils of any sort, and even no nuts or avocado) with moderate dose statins. Its the restrictive rigour and statins that distinguish Esselstyn's approach from similar prior studies (Kempner, Pritikin, Ornish). In time, in some patients the plaque recedes, but the important thing is strong fibrous caps and the near immediate (~2 weeks) reduction of angina.
Esselstyn Jr, C. B. (1999). Updating a 12-year experience with arrest and reversal therapy for coronary heart disease (an overdue requiem for palliative cardiology). The American journal of cardiology, 84(3), 339-341.
Esselstyn, Caldwell et al. (2014). A Way to reverse CAD. J Fam Practice, 63(7), 356-364.
Personally, I think Esselstyn errs a bit in excluding tree-nuts like almonds, walnuts and pistachios, but I've otherwise practiced a similar diet (< 3% saturated fat) as I've some family history with CVD. My total cholesterol is 147 mg/dl as of my last bimonthly blood donation, which places me off the left end of the cholesterol/CVD risk curves. I also don't seem to have the inflammatory and ischemic soreness (back and joint) that seems to afflict a lot of people my age (mid 40s).
Edited by Darryl, 23 August 2014 - 08:41 PM.