Which of the following is a key factor that exacerbates heart failure?

Excess fluid and sodium intake is a key factor that exacerbates heart failure due to its direct impact on fluid balance in the body. In heart failure, the heart's ability to pump blood efficiently is compromised, leading to fluid retention. When there is an increase in sodium intake, the body tends to hold onto water to balance the sodium levels, resulting in heightened blood volume. This increase in volume can place additional stress on the heart, worsening symptoms such as shortness of breath and edema, and can lead to more severe complications.

In contrast, poor sleep quality, low physical activity, and a high-fiber diet, although they may influence overall health, do not have the same immediate and direct effect on heart failure exacerbation as excess fluid and sodium intake. Poor sleep may lead to fatigue, low physical activity can weaken the heart over time, and a high-fiber diet is generally considered beneficial for health, particularly for managing cholesterol and digestive health. However, none of these factors directly contribute to the acute exacerbation of heart failure in the way that managing fluid and sodium levels does.