Ralph L Sacco

Our esteemed friend and colleague, Ralph Sacco, died peacefully on January 17th in New York in the company of his family. He will be greatly missed. Ralph was Olemberg Family Chair in Neurological Disorders and Professor of Neurology at Leonard M Miller School of Medicine at the University of Miami.

Ralph grew up in New Jersey in a busy Italian-American family, and was the first of his family to go to medical school. After completion of his undergraduate degree at Cornell University, he did his medical degree at Boston University, where he first discovered his lasting passion for stroke prevention, working under the mentorship of Philip Wolf on the Framingham Study. By the time he was an intern, he had published his first two lead-author papers on stroke risk, an early marker of his star qualities. He completed his training with a Neurology residency in Columbia University Medical Centre in New York, followed by a Masters in Epidemiology, before joining the faculty at Columbia.

From the beginning, Ralph championed the importance of stroke, with particular focus on prevention in minority and under-served communities, who had been often overlooked in earlier studies. At Columbia, he established the Power to End Stroke initiative with the American Heart Association, focussing on stroke prevention in African-American communities, and the multi-ethnic Northern Manhattan Study (NOMAS). Through his work on NOMAS and related studies, he produced an important body of clinical science clarifying the role of modifiable risk factors for stroke across ethnic groups in the USA, which has informed subsequent policy and prevention initiatives. In 2007, Ralph was appointed Chair of Neurology at the University of Miami. He continued his research in Florida, leading the foundation of initiatives such as the Florida Stroke Registry, Florida-Puerto Rico Collaboration to Reduce Stroke Disparities, and the Family Study of Stroke Risk and Carotid Atherosclerosis. He was also instrumental in driving translational research via his leadership of the University of Miami Clinical and Translational Science Institute.

Ralph joined the American Heart Association as a medical student in the 1980s. He remained a lifelong committed volunteer in the AHA, chairing the Stroke Advisory Committee from 2005-2008, and was elected President in 2010, the first neurologist to hold this position. Typically, in his inauguration speech, he emphasised his goals to increase the focus on stroke and cardiovascular prevention in minority American communities. In 2017 he was elected President of the American Academy of Neurology, the first time that a neurologist had led both AAN and AHA, and served on the World Stroke Organisation Board of Directors. In 2020, he was appointed Editor-in-Chief of the AHA journal Stroke.

A regular visitor to ESOC and Europe, Ralph had many friends and scientific collaborators in ESO, with whom he was always excellent company, often accompanied by good food and wine. He was highly supportive of younger colleagues, which I experienced personally at our first meeting at ISC in the late 1990s. He will be remembered as an outstanding Clinician-Scientist, a role model, a leader, and a friend to many in the field of Stroke Medicine.

Ní bheidh a leithéid ann arís (We will not see his like again soon).

Peter Kelly,

University College Dublin

President, European Stroke Organisation