By AMERICAN HEART ASSOCIATION NEWS
When a longtime patient started experiencing dangerously high blood pressure, Donald Lloyd-Jones, M.D., asked about her dietary habits, which included a daily bowl of soup from a chain restaurant.
He asked her to try a more sodium friendly option. Her blood pressure dramatically dropped — without medication. But Lloyd-Jones took it a step further, inviting the CEO of the restaurant to discuss strategies to reduce sodium on the menu.
“Gradual reductions in sodium are not noticeable by customers, so changing toward safer, better flavors is one way to make the healthy choice the easy choice without affecting consumer perceptions or the bottom line,” said Lloyd-Jones, a cardiologist and the chair of the department of preventive medicine at Northwestern University Feinberg School of Medicine.
Lloyd-Jones, named American Heart Association’s Physician of the Year in Dallas last month, is known as the “father” of Life’s Simple 7, which outlines how to achieve ideal cardiovascular health. Getting more people heart healthy is part of a bigger, loftier health goal that the AHA is aiming to achieve in the next three years. It’s also in line with the goals that Lloyd-Jones began setting early in his career.
Lloyd-Jones grew up outside New York City in Dobbs Ferry, a town of 10,000 on the Hudson River. His family moved to Dallas for the last two years of high school, where he attended St. Mark’s School of Texas. His interest in “science plus people” pushed him toward the medical field. He earned his bachelor’s degree from Swarthmore College, his medical degree from Columbia University and completed his medical training at Massachusetts General Hospital.
He quickly found that he loved taking care of patients. After medical residency and a cardiology fellowship, he was enamored by research, especially research on people.
“By the time I got to residency, I had superb clinicians who were also great teachers. That was very much what I wanted to be,” Lloyd-Jones said. Ultimately, he married his love of people with his love of data, earning his master’s degree in epidemiology.
“I get to work intimately with patients, but through my research I hope I get to have an impact on whole populations of people and help prevent catastrophic illnesses,” he said.
Many clinicians are familiar with the Framingham Heart Study, which tracks cardiovascular disease across generations. But unlike many, Lloyd-Jones got to experience it from the inside between 1997 and 2004. The goal of the study, which started in 1948, is to identify common factors that contribute to cardiovascular disease by tracking a large group of people that hadn’t yet developed symptoms. Almost 70 years later, the original group is almost gone, but studies continue with the second and third generations.
Lloyd-Jones’ research spread widely. Then, in the late 1990s, he was asked to look at the lifetime risks for coronary heart disease in the same way breast cancer lifetime risks had been evaluated.
“We applied the methods to coronary heart disease, and what we found was pretty astounding,” he said. “During their lifespan, one in two men and one in three women will experience a coronary event.”
The striking findings were the overall high risks for coronary disease, and that women faced a much higher risk of heart disease than breast cancer. But at the time very few women realized it.
Previously, Lloyd-Jones had thought of himself as an “extraordinarily indifferent” statistics student. But “the power of these data convinced me that I shouldn’t be indifferent to it anymore,” he said.
Lloyd-Jones joined the AHA as a volunteer in 1997. Before the turn of the millennium, the AHA had set a goal of preventing deaths from heart disease and stroke 25 percent by 2010.
“During that decade, the AHA achieved its goals — early. The AHA was a critical driver in improving death rates,” Lloyd-Jones said. “That was transformative for me in terms of understanding the power of the American Heart Association and what we can do with policies and programs to influence population health.”
The organization decided a bolder plan was needed, so a goal to improve the cardiovascular health of all Americans by 20 percent while reducing deaths from cardiovascular diseases and stroke by 20 percent by 2020 was born. As chair of the writing group that defined the AHA’s 2020 Strategic Impact Goals, Lloyd-Jones has arguably the most complete insight into the metrics of the goals, and what it will take for the AHA to achieve them.
“It is a bit of a mixed picture,” he said. “When we set those targets, we made sure they were stretch goals because we didn’t want the AHA to be too comfortable with them.”
But the impact of obesity means that getting to the full 20 percent reduction will be extremely difficult. Lloyd-Jones believes that making the healthy choice the easy choice is vital in the food supply, diets and with physical activity.
“We need to do more than prevent deaths. We need to promote health,” he said. “We need to continue to keep our foot on the throat of tobacco and get to end game for smoking. And we need to start early to get our kids off to a good start in maintaining the high cardiovascular health we are born with, rather than trying to restore it after it is lost.”