The serendipitous path that led Donald Lloyd-Jones to becoming AHA president

To best understand Dr. Donald Lloyd-Jones, start with knowing about Esther McDonald.

McDonald was 19 when she graduated from Northwestern University, an accomplishment even more impressive considering it was 1920 and few women were going to college. By 33, she pulled off another feat by becoming a full professor at Teachers College of Columbia University.

Over 38 years there, McDonald helped pioneer the field of student guidance counseling. Her pupils became the first generation of counselors, bringing the concept to secondary schools and colleges across the country.

To Lloyd-Jones, she was Nana.

Growing up, he spent countless weekends alone with her at a lake house in New Jersey. Not one for silence, she filled the hours with stories about her work, her students and her many other interests. He also savored her joyful quirkiness. The best example is the family's distinct, somewhat regal-sounding surname. She invented it by slapping a hyphen between her husband's middle and last names so she and her kids "wouldn't be a plain old Jones."

Maybe it's just a coincidence that he went to medical school at Columbia. And that he's worked at Northwestern since 2004.

But the fact he became a teacher absolutely traces to McDonald. Ditto for his emphasis on equity, his knack for leadership and more of the traits and values that led to him become chairman of preventive medicine at Northwestern Medicine in Chicago and — starting July 1 — the 85th president of the American Heart Association.

Lloyd-Jones' journey to the AHA's top volunteer role is the kind of tale McDonald would've loved. It's filled with serendipitous moments and powered by prescient mentors, a love of learning and several quirky asides.

***

The tale begins in the mid-1960s. His parents — Donald J. Lloyd-Jones and wife Beverly — had three daughters who weren't interested in football. According to family lore, the couple had another child in hopes of giving dad someone to share his love of the New York Giants. He too carried the first name of Donald, although a different middle initial.

The elder Lloyd-Jones was a longtime aviation executive, ultimately becoming COO of American Airlines. He traveled plenty, so Beverly ran the house. She enforced the family's primary rule: fairness.

Their oldest daughter, Anne, was 7 when Don arrived. She became his second mom, teaching him to read when he was 3 and sparking a love of history.

The family lived in Dobbs Ferry, a suburb of New York City, where American was based. Don was going into his junior year of high school when American — and the Lloyd-Jones family — moved to Dallas.

Don became a goalkeeper on his new school's soccer team. Being part of a team while carrying an outsized responsibility awakened part of his personality.

"That was my first taste of leadership," he said.

Next, he went to Swarthmore College in Pennsylvania. Started by Quakers, it's a liberal arts bastion with a strong emphasis on social justice. It's also become a family tradition.

"My mom and dad met at Swarthmore," he said. "My dad was on the board at the time I went there. And two of my sisters went there. Another sister who's two years older than me was there at the time."

Don played soccer and lacrosse. He went to other sporting events dressed as the school's mascot: the Fighting Little Quaker. "It's a triple misnomer," he said, because the school was no longer affiliated with the Quakers, Quakers don't fight and, at 6-foot-8, "I'm far from little."

Don also joined student government. His senior year, he was class co-president.

Organization rules required everyone to speak and consensus to be reached before making any decision. This made sense to a guy raised to value fairness. Still, seeing it in action became another building block in his development.

"Once all perspectives are heard, you really have to try to find the common ground," he said. "I'm so glad that my parents taught me to be receptive to that."

***

Lloyd-Jones majored in history strictly to indulge his hobby. Early on, he aimed to attend medical school.

At Columbia, he found his calling once he started studying cardiology. He headed to residency at Massachusetts General Hospital in Boston planning to one day see patients and teach classes.

Then serendipity began steering him.

The condition of unstable angina had just been defined, but there wasn't much data on its risk factors and outcomes. Dr. Chris O'Donnell asked Lloyd-Jones to help figure it out.

Having hardly done any scientific research in college, this was his crash course. He basically moved into the hospital basement studying a year's worth of patients' paper charts. His reward: Being the lead author on many ensuing papers. It also led to a role in the Framingham Heart Study, the long-term research project that revolutionized treating and preventing heart disease.

Lloyd-Jones was in the office of study director Dr. Daniel Levy one day when Levy received a call from Dr. James Cleeman, leader of the cholesterol education program at the National Heart, Lung, and Blood Institute. Levy put it on speakerphone.

A recent campaign around the fact that 1 in 8 women experience breast cancer during their lives catalyzed a surge of mammograms. Cleeman wanted to inspire a similar rush for cholesterol checks. So he asked Levy for the lifetime risk of cardiovascular disease, guessing that the risk might be even higher.

That number didn't exist. Levy asked Lloyd-Jones if he wanted to figure it out.

"Sounds like fun," he said.

Lloyd-Jones found a lifetime risk of 1 in 2 for men and 1 in 3 for women.

***

Around this time, Framingham released a new way to estimate a person's 10-year risk of cardiovascular disease.

It was a great tool with, Lloyd-Jones believed, room for improvement.

Because it was based mostly on male heart patients in a predominantly white city outside Boston, he wanted to replicate it with a variety of ages and ethnicities across genders. Those ideas were percolating when Lloyd-Jones headed to a conference to present research on lifetime risk.

The conference was in Honolulu. The sun and sand proved so attractive that no one came to Lloyd-Jones' presentation. He spent the session chatting with another stood-up scientist, Dr. Philip Greenland.

Lloyd-Jones told Greenland his ideas regarding the potential for calculating more and better risk scores by tapping into more diverse patients. He gave his diatribe without knowing Greenland was looking for new faculty to join his department of preventive medicine (of which Greenland was chair) at Northwestern Medicine.

"I would've been more nervous if I had known!" Lloyd-Jones said.

Months later, Lloyd-Jones was working for Greenland.

Years later, Lloyd-Jones succeeded Greenland atop the department.

His rise was powered by exactly what he'd described in Hawaii.

Lloyd-Jones' study to examine the lifetime risk for cardiovascular diseases across Framingham, plus 20 more studies that included Black, Latino and Asian people, yielded Lloyd-Jones' first independent grant, and now over 40 papers. More than 15 years later, researchers continue relying on that initial harmonized, and now updated and expanded, data set.

"It's definitely the gift that keeps on giving," Lloyd-Jones said.

Another reason Lloyd-Jones left Framingham was to "spread my wings a little bit." That included devoting more time to the American Heart Association.

O'Donnell, his pal from Mass General, brought Lloyd-Jones onto the AHA's statistics committee. Lloyd-Jones became the committee chairman just when the AHA began working toward the 2010 release of its 2020 Impact Goal. And it just so happened that his committee oversaw its creation.

The AHA's previous decade-long goal targeted reducing coronary heart disease, stroke and risk. This time, a big part of the aim was improving cardiovascular health.

While that sounds straightforward, it wasn't. There was no way to measure improvements to cardiovascular health because there was no definition of cardiovascular health.

Good thing Lloyd-Jones knew all about defining the undefined, having been thinking about cardiovascular health as a concept presaged by mentors at Northwestern, like Greenland and Dr. Jeremiah Stamler (his department's founding chair, who also helped found the AHA's Epidemiology and Prevention Council).

His committee determined ideal cardiovascular health stemmed from smoking status, physical activity, diet, weight, blood sugar, cholesterol and blood pressure. Then-AHA President Dr. Clyde Yancy dubbed them "Life's Simple 7."

"With that, a great phrase was born," Lloyd-Jones said. (A dynamic duo, too. Acquaintances then, Lloyd-Jones and Yancy bonded quickly. Lloyd-Jones later helped lure Yancy to Northwestern. They're now best friends.)

Lloyd-Jones also became a staunch believer in using those metrics of cardiovascular health earlier and earlier in a person's life. Their research has spooled back from end-of-life to gestation. Next up is studying the impact of a mom's cardiovascular health on offspring even before she gets pregnant.

"It's incredibly fun research," Lloyd-Jones said. "And if I hadn't been in the right place at the right time to help define cardiovascular health, I never would be doing this."

***

Intrigued by his work on the AHA's statistics committee, Lloyd-Jones became president of the Chicago metro division. He joined and led his regional board. Nationally, he led the committee that plans Scientific Sessions, the AHA's flagship conference.

He experienced advocacy wins and losses from Chicago to Congress. He helped shape education efforts from grade schools to consumer campaigns. For all his work, he was named Physician of the Year in 2017. He also came away with a sense of the AHA's reach beyond its base of scientific research.

He was considering seeking a spot on the national board when the pandemic broke out.

Then AHA CEO Nancy Brown called to offer him the presidency.

"That was the biggest surprise I'd had in a long time," Lloyd-Jones said.

The goal of his tenure is no surprise. He wants all Americans to get on a better cardiovascular health trajectory, from the beginning of life.

It's not about promoting Life's Simple 7 and his ongoing research. It's rooted in research showing that focusing on those risk factors is the best way to prevent cardiovascular disease, cancer and many more chronic diseases of aging. That includes the most damaging effects of this pandemic — and perhaps the next.

While he hopes to encourage adults to adopt healthier lifestyles, the value play is targeting youth and future generations.

"It's a big scope, but this is the moment we're in," he said. "We have to do it now."

***

When Lloyd-Jones was young, his parents fed his love of history — particularly the Civil War — by taking him to the Gettysburg National Military Park. In turn, that launched his love of national parks.

He's seen most of them. He calls Yosemite "the most amazing place on earth" and considers a recent winter visit to Yellowstone among his most spectacular trips. He's filled his home with framed art deco postcards from the parks and a robust collection of photo albums.

"When I've had a tough day, those pictures get me calm and centered," he said.

His enthusiasm is shared by his wife, Kathleen McKibbin, and their three kids. Kathleen is an internist at Northwestern and, Lloyd-Jones proudly notes: "She's a great doc and is underwhelmed and unimpressed by me. She keeps me humble."

Their oldest child, Cameron, graduated from Northwestern two years ago and is now doing cutting-edge science called top-down proteomics. Their second child, Adam, is a rising senior at Swarthmore, majoring in history and leaning toward attending medical school. Their youngest, Caroline, is a rising junior in high school with no interest in medicine.

"We never wanted this to be a default career for our kids," he said. "But it's fair to say they heard a lot about it at the dinner table."

Lloyd-Jones keeps his heart pumping by riding his indoor bicycle and he's always eager to read a new history book. Much to the delight of his late dad, he became — and remains — a Giants fan. (Yankees, too.) Dad also would be happy to know that his oldest daughter has been on the board at Swarthmore.

He and his sisters still own the New Jersey lake house. They gather together every Christmas with their spouses and offspring, a joyous reunion of 20-plus folks. The siblings also own a farm in Indiana, providing yet another reason to stay in touch.

It's a full life and Lloyd-Jones knows it.

As he prepares to become AHA president, he marvels at the twists and turns that led him here.

"The prominence of research in my career has been a shock to both my wife and me," he said. "I can never claim to have engineered any of it. Hopefully, I've made the most of those opportunities, and am making a difference improving and enhancing people's health."