Aneurysmal Rupture Triggers Include Drinking Coffee

Highest population-attributable risks seen for coffee consumption and vigorous physical exercise

THURSDAY, May 5 (HealthDay News) -- Eight triggers that increase the risk of aneurysmal rupture have been identified, including drinking coffee and vigorous physical exercise, according to a study published online May 5 in Stroke.

Monique H.M. Vlak, M.D., from the Utrecht Stroke Center in the Netherlands, and colleagues identified and quantified trigger factors for aneurysmal rupture. Exposure to 30 potential triggers was assessed by means of a questionnaire completed by 250 patients soon after suffering from an aneurysmal subarachnoid hemorrhage (hazard period). Exposure to triggers in the hazard period was compared to the usual frequency of exposure to assess the relative risks (RRs) of rupture after trigger exposure. Population-attributable risks were also calculated.

The investigators identified eight triggers that increased the risk for subarachnoid hemorrhage. These were drinking coffee (RR, 1.7) or cola (RR, 3.4), anger (RR, 6.3), startling (RR, 23.3), straining for defecation (RR, 7.3), sexual intercourse (RR, 11.2), nose blowing (RR, 2.4), and vigorous physical exercise (RR, 2.4). Trigger factors that contributed most to ruptures were coffee consumption (10.6 percent) and vigorous physical exercise (7.9 percent).

"All triggers induce a sudden and short increase in blood pressure, which seems a possible common cause for aneurysmal rupture. Some triggers are modifiable, and further studies should assess whether reduction of exposure to these factors or measures preventing sudden increase in blood pressure decrease the risk of rupture in patients known to have an intracranial aneurysm," the authors write.

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