Thanks for the great question!!!
The first is where the extra cholesterol plaque goes when heart disease is reversed through diet and lifestyle change. This is difficult to answer with 100% confidence, however the thought is something called “reverse cholesterol transport”. Your HDL cholesterol can actually take cholesterol from plaque to the liver where it can be metabolized and eventually excreted into the bile and eliminated in your stool. Yes…you poop out your heart disease!
Also, as inflammation decreases, inflammatory cells decrease in the plaque as well which will give the appearance of a smaller blockage and reversing the overall amount of plaque. Understanding this will help answer your second question. The plaque does not break off and travel downstream causing blockage in smaller arteries. No need to worry about that!