Abstract
Background: Managing physiological risk factors (blood pressure, lipids, stress, blood glucose) post-stroke is essential yet challenging. In this sub-study of a feasibility randomized controlled trial, we examined changes in these parameters following a stroke-tailored mindfulness-based intervention (MBI) compared with an attention control. Methods: Participants 3-18 months post-stroke were recruited from the Australian Stroke Clinical Registry (May 2021-July 2023) and randomized 1:1 to a 12-week MBI (weekly yoga + ≥3 home meditation sessions) or attention control (education and peer support). All attended weekly 60-min classes. Outcomes included blood pressure and stress (perceived stress scale, hair cortisol). A sub-group (n = 17) also had HbA1c and lipid profile assessed. Descriptive statistics, within-group effect sizes (Cohen's d), and generalized linear modeling were used. Results: A total of 38 participants were randomized with 36 participants completing the trial (mean age 69 years; 72% male), and the MBI group showed greater within-group improvements in blood pressure, with clinically meaningful reductions in systolic (5 mmHg; d = 0.35) and diastolic (4 mmHg; d = 0.41) values, compared to smaller effects in the control group. Exploratory trends suggested favorable change in lipid profiles (HDL and LDL) in the MBI group, while triglycerides improved in the control group. No changes were observed for HbA1c. Stress markers, including hair cortisol, showed positive trends in the MBI group (d = 0.52). No significant between-group differences were detected. Conclusions: This sub-study of a well-designed, rigorous feasibility trial provides preliminary findings of clinically meaningful differences in blood pressure and lipid profiles in the MBI group. The findings support the potential of MBIs in managing post-stroke cardiovascular risk factors and warrant larger trials to confirm these preliminary effects.