Exercise, healthy diet key to avoiding death by work stress
Too much pressure at work can lead to heart issues
One was a political reporter who died of heart failure in her sleep after clocking up nearly 160 hours of overtime the month before.
Another, a rookie at an advertising firm, buckled under the stress of a gruelling schedule and workplace harassment and leapt to her death.
These are just two cases that make up Japan's notorious overtime culture, which made headlines recently.
Called karoshi, it refers to death caused by conditions related to overwork.
These include stroke, heart attack and suicide.
A similar overtime culture exists in South Korea (kwarosa) and China (guo lao si).
Most studies consider a job to be stressful when the worker feels that he has little or no control, said Dr Paul Chiam, a cardiologist at Mount Elizabeth Hospital.
"Let's say you have a highly demanding job. If you have minimal power to make decisions about your daily tasks, that makes it a lot more stressful than if you have some control.
"If you love your job and enjoy what you are doing, then putting in long hours is not going to have too much impact," he said.
One of the problems with work stress is that often, the unhealthy coping mechanisms lead to increasing the risk to the heart, said Dr Ong Hean Yee, also a cardiologist at Mount Elizabeth Hospital.
Common culprits are overeating, which elevates high blood pressure and cholesterol levels, smoking and physical inactivity.
Said Dr Ong: "People often turn to comfort foods like fast food and desserts when they are anxious or under pressure.
"These high fat, high cholesterol foods may lead to high blood pressure and diabetes, which contribute to the artery damage that causes heart attack and stroke.
"Similarly, some people turn to alcohol or cigarettes. These habits can increase blood pressure and damage the lining of the heart arteries."
Dr Chiam said those deprived of sleep due to odd working hours and shift work may also suffer from high blood pressure and heightened levels of a stress hormone called cortisol, which increases blood pressure and blood sugar.
That in turn raises the risk of heart disease, he said.
More recently, scientists have found that people who have heightened activity in a part of the brain linked to stress - the amygdala - are more likely to develop heart disease.
Said Dr Ong: "The amygdala is responsible for telling the bone marrow to temporarily produce more white blood cells, which fight infection and repair damage. However, chronic stress can lead to an overproduction of white blood cells, which can result in plaque formation in the arteries and lead to heart disease."
While karoshi is not prevalent in Singapore, our fast-paced and competitive society contributes considerably to stress at work.
Said Dr Chiam: "In many situations, we cannot reduce the job stress that we face.
"We can help ourselves by getting regular exercise, not smoking, adhering to a sensible diet, and screening for and controlling cardiovascular risk factors for heart disease, such as diabetes, high blood pressure and high cholesterol."