The Multicenter Lifestyle Demonstration Project was designed to determine if comprehensive lifestyle changes can be a direct alternative to revascularization for selected patients without increasing cardiac events. A total of 333 patients completed this demonstration project (194 in the experimental group and 139 in the control group). We found that experimental group patients were able to avoid revascularization for at least 3 years by making comprehensive lifestyle changes at substantially lower cost without increasing cardiac morbidity and mortality. These patients reported reductions in angina comparable with what can be achieved with revascularization.