Globally, Japan, Taiwan, and South Korea are the countries recognizing cardiovascular diseases (CVDs) due to overwork as work-related diseases and compensate those who suffer from them. In Japan CVDs are considered to result from overwork. In addition, the underlying diseases (hypertension, atherosclerosis, and diabetes mellitus) of those who suffer from such diseases are recognized in Japan as being significantly facilitated and aggravated by overwork, especially the accumulation of fatigue from long working hours. Thus, the manifestation of CVDs is considered to be work-related. Initially, South Korea began with criteria for work-related CVDs (WR-CVDs) similar to those developed by the Japanese. However, South Korea has revised certain areas of the criteria many times for administrative and social reasons, without any basis of scientific evidence or support 1) . CVDs are the number one cause of death in the adult population, not only in Korea but globally. Although the patient may survive a stroke or myocardial infarction (MI), it can cause a permanent physical disablement, thus obstructing work ability. This disability can be tragic for the individual and the family, and may be a big loss for the company and the nation that loses a member of a skilled and important workforce. Due to the dramatic development of medical knowledge over the years, the pathophysiology of CVDs has been determined and new risk factors such as inflammation or stress have been included. In addition, what in the past has been collectively termed ischemic heart diseases has now been differentiated into coronary artery disease (CAD) and acute coronary syndrome (ACS). Following these clinical developments, there must be a process of verifying whether the many epidemiological studies that have presented scientific evidence for the association between stress and the causal risks of CVDs agree with the new medical knowledge. Moreover, South Korea is currently greatly influenced by both Japan and the West on the issue of WR-CVDs. There is therefore a need for a definite clarification of the difference between the West’s concept of job stress and Japan’s focus on overwork and how each factor influences health. Based on recent scientific evidence, the criteria on the work-relatedness of CVDs need to be revised, not only to improve the fairness and decision time for claims regarding work-related diseases, but also to prevent CVDs more effectively. Work-related diseases are preventable by controlling those work-related factors that are involved in the occurrence of such diseases, as well as in the facilitation or aggravation of CVDs. Workrelated causal factors should therefore be the subject of scientific investigation. Accordingly, this paper discusses 1) the differences between CAD and ACS, 2) the differences in how job stress and overwork influence CVDs, 3) the differences between cerebrovascular diseases and CVDs in terms of the etiopathogenesis, and 4) necessary revisions to the method for preventing workers’ CVDs and the criteria on the work-relatedness of CVDs.