The biggest stressors usually fall into two categories: factors that increase workload and factors that damage vascular function. Uncontrolled high blood pressure forces the heart to pump against higher resistance, creating chronic strain over time. Smoking and nicotine constrict blood vessels and reduce oxygen delivery, making the heart work harder. Physical inactivity and excess body weight increase cardiac workload and amplify metabolic risk. Sleep deprivation, chronic stress, and heavy caffeine intake can increase rhythm sensitivity in some individuals. Diet patterns high in sodium, refined sugars, trans fats, and ultra-processed foods can worsen blood pressure, inflammation, and lipid balance—accelerating long-term wear. Finally, inconsistent medication use or unmanaged chronic conditions keep the heart under continuous pressure. In other words, what strains the heart most is rarely a single event; it is a prolonged set of suboptimal systems operating daily.