From “Global, Regional, and National Burdens of Ischemic Heart Disease and Stroke Attributable to Exposure to Long Working Hours for 194 Countries, 2000–2016: A Systematic Analysis from the WHO/ILO Joint Estimates of the Work-Related Burden of Disease and Injury”: “Evidence from previous studies suggests working long hours can increase mortality and morbidity from ischemic heart disease and stroke through psychosocial stress. Two primary causal pathways are conceivable. The first is through biological responses to psychosocial stress: release of excessive stress hormones due to working long hours may trigger functional dysregulations in the cardiovascular system and structural lesions. The second pathway is through behavioral responses to stress that are established cardiovascular risk factors, including tobacco use, harmful alcohol use, unhealthy diet, physical inactivity, and resultant impaired sleep.”