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From the article:

Calculating population attributable risk – the fraction of subarachnoid hemorrhages that can be attributed to a particular trigger factor – the researchers identified the eight factors and their contribution to the risk as:

-Coffee consumption (10.6 percent)

-Vigorous physical exercise (7.9 percent)

-Nose blowing (5.4 percent)

-Sexual intercourse (4.3 percent)

-Straining to defecate (3.6 percent)

-Cola consumption (3.5 percent)

-Being startled (2.7 percent)

-Being angry (1.3 percent)

“All of the triggers induce a sudden and short increase in blood pressure, which seems a possible common cause for aneurysmal rupture,” said Monique H.M. Vlak, M.D., lead author of the study and a neurologist at the University Medical Center in Utrecht, the Netherlands.

Risk was higher shortly after drinking alcohol, but decreased quickly, researchers said.


Although physical activity had triggering potential, researchers don’t advise refraining from it because it’s also an important factor in lowering risk of other cardiovascular diseases.

“Reducing caffeine consumption or treating constipated patients with unruptured IAs with laxatives may lower the risk of subarachnoid hemorrhage,” Vlak said. “Whether prescribing antihypertensive drugs to patients with unruptured IAs is beneficial in terms of preventing aneurysmal rupture still needs to be further investigated.”

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