Andrew Mahoney, Jr., a 43-year-old father of three, learned from his doctor that he had high cholesterol and should take a statin drug. He filled the prescription, but usually neglected to take the pills.
"I wasn't ready to start a lifetime regimen of taking drugs. I don't even take aspirin!" says Mahoney.
Bill Clinton was also prescribed a statin and stopped taking it. Many doctors think that may have played a role in his getting heart disease.
About 15 million Americans have prescriptions for statins. Government guidelines say the number should be three-times that many. But studies show that about one-quarter of the time, even those with prescriptions don't take the pills.
"This is probably the biggest problem in the treatment of cholesterol right now," says Dr. Christopher Cannon, a cardiologist at Brigham and Women's Hospital in Boston.
For some, like Dennis Rising, the $100-a-month cost of the drugs presents a huge barrier.
"I'm working part time a couple times a week — at least once a week — so I can afford the medications," says Rising.
Others — about one percent — suffer side effects including muscle pains.
But most often people like Andrew Mahoney just don't like the idea of taking the medications for a variety of reasons, including feeling like they have somehow failed.
"For treatment of cholesterol there actually has been so much emphasis on changing diet and exercise as the way of treating it that it does make you feel guilty if your cholesterol is too high, but in fact it's not your fault," says Dr. Cannon.
The experts say millions of Americans cannot achieve the cholesterol goals with diet. Statin drugs can reduce their risk of heart disease by 40 percent if they take the pills.