I'd definitely take statins. I know there's some controversy around them. I've spoken with two cardiologists, one from Mayo, and their thinking is that the progression can be stopped.

My diagnosis is less than a year old. I've had a good lifestyle by most standards, but it was not pristine. Since then I've essentially cut out consumption of animal protein. I cut out beef around 30 years ago, but now I've also cut out lean turkey and chicken except on holidays. It's my treat. After I read "Beat the Heart Attack Gene" I started monitoring my blood sugar and found that I was pre diabetic (by an OGTT). I wore a CGM for a couple of months to get a handle on it so now I move a lot more over the course of the day, rather than exercising and then sitting for long periods. I try to move more after dinner too. I probably ate bread most days and dessert once or twice a week, but now I rarely eat bread, try not to eat dessert more than once every couple of weeks or so, and definitely go for a walk after anything sweet. My A1C dropped a few (3) tenths. I also worked with a cardiac dietician to get my BP down. I had mixed results. I think I've learned that my high BP is either genetic or stress-induced. Dietary changes she predicted would lower it have not (yet). I have osteopenia (apparently somewhat associated with atherosclerosis) so I have also started taking K2 FWIW. I've also added consumption of fermented foods regularly -- just trying everything that seems a little hopeful.

So I think there are things to be done now and I believe that there are things I could have done that were known 10 years ago - if I knew I were at the risk that I apparently was. But who knows. It's all speculation and it's water under the bridge.