Effect of different Lifestyle Interventions on Vascular Risk factors and Arterial stiffness in Non-disabling Stroke and Transient Ischemic Attack (TIA) patients

INTERVENTION: Baseline assessment ‐ finger prick samples to measure blood profile markers. 12‐lead ECG exercise stress test, to sub‐maximal exhaustion (8mins) and images of the carotid artery via a pulsecor. Exercise Intervention ‐ 12 weeks, 40mins x 2 p/wk ARM 1 Aerobic ‐ 40mins of aerobic exercise ‐Starting at 75% HRR with an increment of 10% every 4th week i.e. 75%, 85%. 95% HRR. Protocol = interval training – 1min exercise; 15secs rest. Completed on treadmill or stationery ergometer. ARM 2 Resistance ‐ 40mins of circuit‐resistance exercise – Starting at 75% HRR with an increment of 10% every 4th week i.e. 75%, 85%. 95% HRR. Protocol = interval training – 1min exercise; 15secs rest of 8 exercises (upper and lower body) x 4 sets ARM 3 12‐weeks of Nutritional education and group sessions, 2 x 45‐60mins p/wk, will be undertaken at Wellington Hospital or other identified location for cooking demonstrations by dieticians. The nutritional guidance will be based on a whole foods plant based diet. Patients will be educated on the benefits of such a diet in regards to vascular risk factor control and reversal of atherosclerosis. Continued sessions will also concentrate on how to achieve this type of diet through group sessions and cooking demonstrations Strategies to improve adherence: Exercising in a group setting Clinical Exercise Physiologists present at each exercise session to help monitor and ensure safety of participants CONDITION: Non‐disabling stroke Transient Ischaemic Attack PRIMARY OUTCOME: Two composite primary outcomes: ; ; Aterial stiffness/compliance of carotid artery ‐ ; ; Using ultrasonography and pulse wave analysis (thickness of interior walls, and carotid blood velocity) ‐ improvement would be recorded as greater then baseline assessment. ; ; Central blood pressure ‐ Sysytolic blood pressure decrease of 5mmHg ; ; Vascular risk factors as assessed by finger prick blood sample measures, significant if there is a decrease in blood profile markers: total cholesterol [TC], high‐density lipoproteins [HDL], low density lipoproteins [LDL], triglycerides [TG], TC:HDL ratio, fasting blood glucose (FBG) SECONDARY OUTCOME: Physical fitness ‐ measured by heart rate at perceived levels of exertion; resistance at certain levels of perceived exertion when competing an exercise ECG submaximal stress test INCLUSION CRITERIA: Inclusion criteria – located within CCDHB; diagnosed with non‐disabling stroke/TIA by stroke physician. ABCD2 > 4 for those diagnosed with TIA for an indication of severity.