Why is it healthy to strain your heart through exercise, but unhealthy to strain it through stress, caffeine, nicotine etc? What is the difference between these kinds of cardiac strain?
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AFAIK, exercise leads to increased oxygen demand in your muscles, and can induce a relative lack of oxygen. The body will adapt: it will grow more small blood vessels to the muscles for oxygen delivery, it will increase your body’s capacity of taking up oxygen, it will increase the effectiveness of oxygen use in the muscle by increasing the number of mitochondria in muscle cells, it will increase the number of muscle fibers, etc…
Drugs like the ones you mentioned will likely stress the heart to some extent, similar to exercise, but will probably not lead to this degree of physical adaptation. In addition, chronic stress or cocaine use, for example, can lead to hypertension, which will lead to damage of the blood vessels, which could lead to stroke, heart attack, peripheral artery disease, renal disease, etc…
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