What is the pathophysiology of karoshi (sudden death from overwork)?

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From the Research

Karoshi death is primarily caused by severe physiological stress from overwork, leading to cardiovascular or cerebrovascular catastrophes, with the most recent and highest quality study suggesting that long working hours, job-related stress, and poor work-life balance are the main contributing factors 1. The pathophysiology of karoshi death involves chronic stress activating the sympathetic nervous system, leading to sustained high levels of stress hormones like cortisol and catecholamines, as reported in a study published in the Acta neurologica Taiwanica 2. This causes persistent hypertension, increased heart rate, and elevated blood glucose, which over time promote atherosclerosis, endothelial dysfunction, and hypercoagulability. Some key points to consider in the pathophysiology of karoshi death include:

  • Chronic stress and its effects on the sympathetic nervous system
  • The role of stress hormones like cortisol and catecholamines in promoting cardiovascular disease
  • The impact of long working hours and poor work-life balance on cardiovascular health
  • The importance of addressing work-life balance, stress management, and regular health screenings in preventing karoshi death, as highlighted in a study published in the Risk management and healthcare policy journal 1. The body's inability to recover due to insufficient rest periods exacerbates inflammation and oxidative stress, while sleep deprivation further disrupts metabolic processes and blood pressure regulation. In susceptible individuals, particularly those with pre-existing cardiovascular risk factors, this chronic physiological burden can culminate in acute myocardial infarction, stroke, heart failure, or fatal arrhythmias, with the final event typically involving plaque rupture, coronary thrombosis, or cerebral hemorrhage triggered by a surge in blood pressure during acute stress. Prevention of karoshi death requires a multifaceted approach, including:
  • Addressing work-life balance and reducing long working hours
  • Implementing stress management techniques and promoting regular health screenings
  • Encouraging adequate rest periods to allow physiological recovery
  • Providing education and support for individuals at high risk of karoshi death, as suggested in a study published in the Fa yi xue za zhi journal 3.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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