By AMERICAN HEART ASSOCIATION NEWS
Ralph L. Sacco, M.D., was still in medical school at Boston University when one of his mentors led him to understand and embrace a critical concept: Something could actually be done about stroke.
Sacco has been driving for change ever since. He has been involved in important scientific research. He became the first neurologist to serve as the American Heart Association’s president. And he was instrumental in bringing the idea of “brain health” to light.
The AHA honored him this month for more than 30 years of service with the Gold Heart Award, the organization’s highest volunteer honor.
“The AHA had made incredible strides to treat, beat and prevent stroke,” Sacco said . “But the idea that what’s good for your heart is good for your brain was a newer concept not yet known by the public or the AHA. Many people are frightened about growing old and losing their cognitive abilities, but there are extra benefits for both the heart and the brain if we can get closer to ideal cardiovascular health.”
The eldest of five kids, Sacco grew up in South New Jersey in an Italian-American family that thrived on feeding people, not healing them.
“My mom never worked,” he said. “She took care of us, while my dad worked in the restaurant business — Italian sandwiches.”
His grandfather started the White House Sub Shop of Atlantic City in 1947. In 1969, his father opened Sack O’ Subs, eventually expanding to five locations.
Sacco worked as a paper boy and in the restaurant, but the family business wasn’t for him.
“I was the first in my immediate family to go to college,” he said. “I had an aptitude for science and math. The medical bug hit me because I had an aunt Dottie who worked for a doctor. Her whispering in my ear, ‘it’s a noble profession, you’ll have a lot of opportunities’ had a big influence on me.”
Sacco majored in bioelectrical engineering and pre-med at Cornell University — which he said prepared him for the rigors of medical school.
The summer after his first year of medical school, he met Philip Wolf, a neurologist and one of the principal investigators of the famed Framingham Heart Study, which studied cardiovascular diseases across three generations of New Englanders. Wolf lit Sacco’s passion for the brain. Later, renowned researcher J.P. Mohr had a big impact.
“J.P. was always challenging the status quo,” Sacco said. “He questioned our fundamental knowledge about the brain and stroke treatment.”
Sacco’s family also influenced his desire to help people make changes for the better. During medical school, Sacco lost his grandmother to heart failure and during his neurology residency at the Neurological Institute at NY Presbyterian Hospital and Columbia University his grandfather had a stroke.
“As a family we dealt with what it was like to see him go from being the vital patriarch of the family to someone who unfortunately was disabled from his stroke,” he said.
At the same time, Sacco started making his own way in the stroke world. In the early 1980s, he was awarded an American Stroke Association medical student scholarship. He worked on a research project in the Framingham Study and as a medical student published two articles about stroke risk factors as first author.
He stayed on at Columbia, eventually rising to full tenured professor, chief of stroke and neurocritical care and associate chairman. Travel was a big part of his life.
“My family was always supportive and proud of what I was doing, but didn’t necessarily understand the life of an academician,” Sacco said. “My mom called me ‘the traveling doctor.’”
The family, in a way, traveled along with him.
When he’d lecture in Philadelphia, attendees would ask, “’Are you related to Sack O’ Subs?’ That’s all they wanted to hear about. They didn’t want to hear about neurology.”
In 1993, Sacco founded the NINDS-funded Northern Manhattan Study to find out what caused stroke in Hispanics. It evolved into a variety of studies looking at cardiovascular disease and brain health and is still ongoing after 23 years.
In 2007, Sacco got an itch to move, landing at the University of Miami Miller School of Medicine, where he remains today as professor and Olemberg Chair of the department of Neurology and executive director of the Evelyn McKnight Brain Institute.
That same year, his mother died after battling heart disease for 15 years. Sacco felt helpless, “knowing that some new valve procedures were being investigated, but not ready to be used in her case.”
That was also the year when, at age 50, Sacco noticed the numbers on the scale climbing. Worried that his family history and eating habits were catching up with him, he put a gym in his house, started biking and began following the AHA’s diet recommendations.
“I have a sweet tooth, which is a problem,” he said. “I love cookies and cakes so I have to avoid them and instead grab a fruit cup.”
He was also a big diet soda drinker, guzzling four to five a day, but his own NOMAS study showed that it was associated with an increased the risk of stroke, heart attack and vascular death. Sacco said he cut them out cold turkey and switched to flavored waters.
“If we can control exercise and diet, we have this whole downstream effect on losing weight, controlling blood pressure, blood sugar and cholesterol,” Sacco said. “At the root of many of these health factors is diet and exercise. They’re fundamental.”
Living a healthier lifestyle, in addition to understanding the science behind it, made it that much easier to promote the AHA’s 2020 Impact Goal during his presidency. The goal, which was relatively new, is to improve the cardiovascular health of all Americans by 20 percent while reducing deaths from cardiovascular diseases and stroke by 20 percent.
Sacco was also a pioneer in the association’s Power To End Stroke movement to heighten awareness of stroke risk in African-Americans, Life’s Simple 7, easy ways for everyone to improve their heart health and the Together to End Stroke Campaign.
Today, in addition to his medical and volunteer work, Sacco enjoys renovating homes in New York and Miami with his partner Scott Dutcher.
His dad, who’s about to celebrate his 85th birthday, has retired from the restaurant business, but some things never change.
Sacco said, “Usually when I come home they have a sandwich waiting for me.”