During the 7 years since the conclusion of the 5-year study, all but 1 patient have continued to ad here to the prescribed diet and medication. Adherent patients have experienced no extension of clinical disease, no coronary events, and no inter ventions. This finding is all the more compelling when we consider that the original compliant 18 participants experienced 49 coronary events in the 8 years before the study. These results are particularly important because they show that arrest and reversal therapy stops, rather than slows, coronary atherosclerosis. We must shift the paradigm from interventional palliative cardiology to arrest and reversal therapy, which achieves numerical lipid goals that, when maintained, will abolish disease extension.
Adherence is the key factor upon which arrest and reversal therapy depends.
Such immediate recognition in achieving lipid goals is critical reinforcement and provides the patient with real-time proof of success. Visits became monthly during the second 5-year pe riod and have been quarterly for the past 2 years. Several times a year a group meeting was held at my home or the home of a participant to review treatment objectives, exchange menus, and socialize. Continued frequent patient encounters appear critical to teach dietary knowledge and reinforce new habits. Patients reported that their physician's commitment to the same diet was additional motivation.