Salpy Pamboukian, M.D.
Professor of Medicine at the University of Alabama at Birmingham
Recently, a 31-year-old Japanese reporter died due to overworking 159 hours of overtime, according to labor inspectors. The official cause of death was attributed to heart failure and "karoshi" a Japanese term for "death from overwork."
Can overworking really cause your heart to fail? UAB Professor of Medicine Salpy Pamboukian, M.D., says yes.
"Not only is the concept of karoshi medically plausible, it is a phenomenon that has been recognized and well described in Asia (initially in Japan) since the early 1960's. There is an expanding literature in peer reviewed medical journals describing the epidemiology and effects of work policy changes on cardiovascular deaths related to karoshi in Asian countries.
Takotsubo cardiomyopathy is a well recognized and studied condition, also known as stress cardiomyopathy or "broken heart syndrome", where sudden emotional stress, such as receiving bad news, results in acute weakening of the heart muscle leading to heart failure or arrhythmias. This condition was also first described in Japan.
It makes sense that chronic stress accumulated over a period of time, such as chronic overwork, could lead to a cardiac event in the same way that a sudden stress could. Elevations of stress hormones in the body (catecholamines) are a normal physiologic response, but over time, long-term elevations can lead to high blood pressure, vasoconstriction, higher resting heart rates, and heart rhythm disturbances.
When people do not have time away from work to "de-stress" these stress-hormone levels could remain high and do not ebb and flow as normal. All this would be further exacerbated by lack of sleep, poor nutrition and lack of dedicated exercise in people who are being overworked. It is plausible that working over a period of weeks or months without appropriate rest could culminate in an acute cardiovascular event.
The need for work-life balance is recognized in North America, but unfortunately does not always translate into work place or societal policies. Due to financial pressures, many people work multiple jobs outside the home, or combine outside work with home obligations to the point they do not have time for adequate self care. Although not as extreme as the case presented in the article you sent, over time many of the same physiologic responses accumulate to adversely affect cardiovascular health."
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