In the spring of 2021, as he prepared to become president of the American Heart Association, Dr. Donald Lloyd-Jones spoke weekly with CEO Nancy Brown about a signature project for his year as the top scientific volunteer.
On his way up the AHA volunteer ladder, Lloyd-Jones – chair of preventive medicine at Northwestern Medicine in Chicago – became best known for leading the team that defined ideal cardiovascular health. That research also identified seven areas a person could improve to reduce risk for heart attack and stroke. Smoking status, along with "knowing your numbers" as they relate to physical activity, weight, diet, blood glucose, cholesterol and blood pressure, became known as "Life's Simple 7."
Since that work was published in 2010, it's been cited in more than 2,500 scientific papers, many of which also offered comments, criticisms and suggestions. Plus, advances in science and technology have paved the way to far more insights than were available a decade before.
So, Lloyd-Jones told Brown, maybe it's time for the AHA to take another look at the best way to define ideal cardiovascular health.
With Brown's enthusiastic support, Lloyd-Jones assembled a panel of standout scientists. They found that the original seven items remain crucial factors – and so does one more: sleep. The details, including more nuanced information for each metric, are in a presidential advisory published Wednesday in the journal Circulation.
The update means a new moniker. Life's Simple 7 has given way to Life's Essential 8.
It also means a tweak to Lloyd-Jones' wardrobe. His ever-present red "7" lapel pin has been replaced by a red "8."
"Redefining his own seminal work exemplifies Don's devotion to science while meeting people where they are in their health journey," Brown said. "This fitting capstone to his tenure as AHA president ensures his impact on our organization, as well as on public health, will resonate for years to come."
This big finish wraps up a year that Lloyd-Jones said exceeded his high expectations. On Tuesday evening, Lloyd-Jones was honored with the Distinguished National Leadership Award at the AHA's National Volunteer Awards.
Like those of his two immediate predecessors – Drs. Bob Harrington and Mitch Elkind – Lloyd-Jones' term was shaped by COVID-19. This meant that while he traveled the world for international meetings, he did so from his laptop.
"There would be days when I would come home from work and say to my wife, 'Well, today I was in Argentina and Korea and Italy,'" he said, laughing.
He also was a trusted voice in countless news interviews about the cardiovascular ramifications of the virus, vaccines, deferred care and other treatments.
"They're such teachable moments, and the AHA was well positioned to provide relevant and much-needed information to help people understand fact from fiction," he said.
Of all the appearances he made, two of his fondest memories are testifying before federal lawmakers and working out with the mascot of the NFL's Chicago Bears.
Lloyd-Jones spoke to the House Subcommittee on Health about gathering data to improve care for people who have an out-of-hospital cardiac arrest, and about expanding cardiac rehab programs. He is passionate about all advocacy opportunities because of the potential reach, so talking to Congress members was especially meaningful.
With the Bears mascot, Lloyd-Jones filmed a video for kids about the connection between being active and being healthy. It was a big part of "NFL Play 60 Super Bowl Brain Break," which has been viewed by millions of students.
He said those events – which happened to come days apart – underscore both the thrill and the scope of the AHA presidency.
"I'm so grateful for getting to experience firsthand the organization's depth and breadth," he said. "As a longtime volunteer, I'm familiar with all aspects. What makes this job so energizing is getting to see the impact in real time."
Yet only one moment caused him to let out a "Wow!" to a crowd of more than 1,000 people and thousands more watching on video.
It came simply from walking on stage at the International Stroke Conference in New Orleans in February. It was the AHA's first in-person science meeting since the start of the pandemic and his first time in front of a large audience in two years.
"It felt like being hit by a strong gust of wind," he said.
Soon after, he attended a gathering with the presidents of many international health societies.
"As we were talking, any number of them made a point of saying how much they respect the American Heart Association because we are so squarely focused on doing the right thing for all people and populations," he said. "It was really cool for me to hear that people running professional societies in their countries or regions think so highly about what we're doing."
Lloyd-Jones' tenure ends July 1, when Dr. Michelle Albert takes over as president. Among the major initiatives he'll hand off is the organization's work toward a 2024 goal of equitably advancing cardiovascular health for all, including identifying and removing barriers to health care access and quality.
Lloyd-Jones proudly noted that $230 million has been committed to addressing these barriers, with more than $100 million in research funding on equity and nearly $100 million for community impact funds. Strides are also evident in other areas of research, leadership and the AHA's portfolio of science journals and meetings.
"We're not new to the equity space; really, we've been here for decades. But now we have such a good, sharp focus and we know we're doing things that will have impact," he said. "More than anybody I know, Michelle walks the walk about equity and disparities and understands the science and the needs behind this. We're in for a really great ride next year."