Nearly 74 million Americans are currently living with high cholesterol, but less than half are actually treating it. Many people don’t know they have high cholesterol, and those who do often assume it will stabilize without treatment. Unfortunately, this isn’t usually the case.

While eating a nutritious diet, exercising regularly, and taking statin drugs can help, they may not always be enough. Sometimes the issue is genetic, and will be diagnosed as HeFH, or heterozygous familial hypercholesterolemia. If left untreated, HeFH puts people at very high risk for a dangerous cardiac event.

Below, explore four people’s personal journeys living with and treating their high cholesterol and HeFH.

Charlotte Micallef, 44 – Diagnosed in 2002

“My high cholesterol affects my day-to-day life [because of] my eating habits and also my medication. I have to take it on a daily basis, and every six months I have to go in for blood tests and get the results and possibly change the dosage. So it’s a constant reminder that I have high cholesterol.

I believe that I need to do this not only for myself, but for my child — and it is important. You need to put yourself first in order to live a happy, healthy life and that’s what I want to do.”

Mary Lu Marr, 60 – Diagnosed in 2012

“I would tell someone who has just had a heart attack that they’re going to have to be diligent in keeping themselves healthy, to follow their doctor’s orders, to take their medication daily, to get some exercise. Just the standard, sensible things to remain in good health.

I think the future is bright for me after my heart attack. I think following a healthy lifestyle will help me lead a normal life. I certainly want to be around to see my grandchildren grow up.”

Michael Baum, 60 - Diagnosed in 1995

“My advice for somebody who has HeFH is to listen to your doctor. And if he prescribes a statin drug, take it because, like myself, sometimes just diet and exercise aren’t enough to do it.

The hardest thing was to cut out the saturated fats. At the time they were recommending like two eggs a week, and eggs were kind of a staple of my diet, so I miss that a lot. But it was important to cut out a lot of the high saturated fat in the diet, and to add more vegetables, more fruits, more grains.”

Rafael Perez, 48 – Diagnosed in 2014

“After I got released from the hospital, I had a whole new outlook on life. My treatment plan was to exercise, eat [well], not to ignore my symptoms, and live a healthy life for a long time.

My hope for the future of my health is that I stay dedicated to my diet, and I stay alive for a long time to watch my kids grow up.”