Coronary Heart Disease Risk Factors: Measures for Reduction

Introduction

One of man’s best inventions is drugs, especially disease-specific ones. Drugs are substances other than food, which can prevent, relieve the symptoms, or cure an abnormality or disease. Globally, the cost of drugs has soared over the years, resulting in a situation whereby low-income earners are unable to buy branded medications. In underdeveloped and developing countries where food and drug agencies have poor capacity to perform their regulatory functions optimally, we tend to see the proliferation of substandard or fake drugs. So many times, this ugly trend is energized by not just greed but by the market demands for affordable medications.

Why Medication exceeds expiry date

 To mitigate the challenge of not being able to buy drugs, when necessary, people from resource-limited settings stack up some essential medications in their homes, which eventually exceed the best before or expiry dates on them. Sometimes, doctors could change a patient’s prescription because of reactions, allergies, or inability to purchase the drug, which could result in leftover drugs that eventually exceed the expiration date. Also, big pharmacies and patent-drug stores cannot sell all their stock, leading to the expiration of some drugs. This situation has raised many questions about the safety of these drugs after their expiration or beyond the “best before” date. Because of the importance of drugs and the health risks involved when taken wrongly, people have always consciously discarded unused drugs when it’s past the expiration date, even one day.

How Safe is a drug after the expiry date?

The debate about drugs being safe after their expiration date has persisted over the years, as many people still hold the opinion that pharmaceutical companies deliberately label their drugs with short shelf lives to guarantee steady patronage. Eventually, most of these unused drugs are discarded. The context that drugs can still be safe for a long time after expiration has gained several affirmations. In a recent study by Benjamin Davido and others titled ‘Efficacy of Expired Antibiotics: A Real Debate in the Context of Repeated Drug Shortages’ published in MDPI Journal “Antibiotics”, it was reported that when appropriately stored in line with the expected conditions, no expired antibiotics tested failed to be potent after one year of expiration. In another study by Sushil Sharma and others, titled ‘A study to investigate the chemical potency, physical stability, and efficacy of analgesic agents over a period of two years post their expiry date’ published in the “Medical Journal Armed Forces India”, it was seen that drugs such as Diclofenac, Piroxicam, and Ibuprofen retained their stability, analgesic efficacy, chemical active ingredients and by implication their potency up to a duration of two years after expiration.

Important factors to consider

However, the issues of proper storage and handling can play a big role, especially in the tropical climate of West Africa and other geographical regions. Hence, people in the tropics may have to rely on their capacity to store their drugs in the required condition in deciding whether to use a drug past the expiration date or not.

Conclusion

This article doesn’t advocate for the use of expired medication but to reduce anxiety about accidental use. It is essential to understand factors that impact drug stability.

(Written by Ebenezer Dic-Ijiewere PhD.)

NB: Always consult your healthcare professionals regarding expired medications to ensure medication safety and effectiveness.

With the government shutdown, many aspects of daily life have been severely impacted. The rate of food insecurity is increasing, and challenges related to housing, transportation, and other social determinants of health are becoming more pressing. SNAP benefits have been frozen, leaving many families struggling to put food on the table. As a result, more individuals and families are turning to food pantries and community resources for support.

At the same time, the cost of food and necessities continues to rise, deepening the struggles faced by countless households. These are difficult times, but I want to encourage everyone affected to stay strong, remain hopeful, and trust that better days are ahead.

Here are some practical ways to cope and survive during the rising costs and government shutdown:

• You must focus on needs such as housing, food, transportation, utilities, and medication.
• Decrease or pause non-essential spending, such as new purchases, entertainment, or dining out.

  Manage Your Money Wisely

• Avoid any unnecessary debt.
• Prioritize rent/mortgage and food.
• Discuss with your utility company, landlord, or bank to explore any available payment plans or deferments during the shutdown.

Explore any available community resources

• Assess community and faith-based resources (Local food banks, churches, non-profits) for support with food and bills.
• Check your city’s website to find out what supports are available to access.

   Protect Your Mental and Emotional Health during the difficult time

• Financial insecurity can be draining. Stay connected with family, friends, and coworkers for emotional support.
• Get good exercise, rest, and be consistent with your routines
• Have faith and be hopeful that the challenges are temporary and will surely pass
• Focus on what’s within your control.

Maintain Perspective

• Use this period to build your financial discipline and strength
• Celebrate each time you pay a bill and make meals; a win is worth celebrating
• Reflect on value by focusing on more relationships, essentials, and faith than on any material things

Overview of Stress: Stress significantly affects health, contributing to disease development and burdening healthcare systems considerably. It is a significant factor in various ongoing health issues, particularly cardiovascular diseases, which are often impaired by everyday psychosocial pressures, such as work-related stress.

The following are the roles of stress in disease development.

Gender Differences in Stress Responses: Gender plays a vital role in how individuals experience and manage stress. Research reports that women are more likely to develop mood disorders and autoimmune. At the same time, men tend to have higher rates of early substance abuse, infectious disease, mortality, and antisocial behavior. Unsuccessful stress management can lead to severe physical and mental health consequences for both individuals and communities.

Physiological Responses to Stress: The study reports that stressful events can trigger emotional responses such as anxiety and worry, impacting the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic-adrenal-medullary (SAM) system, which may lead to unhealthy lifestyle choices, comprising poor sleep, alcohol consumption, decreased physical activity and increased smoking thereby increase the risk of diseases.

Chronic Stress in Specific Environments: Chronic stress in educational settings and workplaces impacts mental and physical health noticeably. Also, it indicates that occupational stress significantly affects mental well-being.

Traumatic Events as a Stress Source: Traumatic events are a prevalent source of stress that affects a large portion of the population. The study reports that In North America, about 60% to 75% of individuals will experience a traumatic event in their lifetime, including serious accidents, exposure to war, sexual assault, chronic childhood abuse, or neglect.

According to the Centers for Disease Control and Prevention (2021), Cigarette smoking damages almost every organ in the body, leading to numerous diseases and overall health decline. In the United States, smoking is responsible for over 480,000 deaths each year, nearly one in five deaths. For women, smoking can make it more difficult to conceive and can adversely affect a baby’s health before and after birth. In men, smoking can reduce sperm quality, decreasing fertility and increasing the risk of congenital disabilities and miscarriage. Smoking also harms oral health, potentially leading to tooth loss. Moreover, it increases the risk of cataracts, which cloud the eye’s lens and impair vision. It can cause age-related macular degeneration (AMD), damaging a small spot near the retina’s center needed for central vision. Additionally, smoking is a risk factor for type 2 diabetes mellitus and can complicate its management, with active smokers having a 30-40% higher risk of developing diabetes compared to nonsmokers.

The four major diseases linked to smoking are

• Cardiovascular Diseases
  • Increased mortality rates due to smoking.
  • Elevated risk of ischemic heart diseases.
• Respiratory Conditions
  • Smoking is a primary cause of chronic respiratory deaths.
  • Increased risk of respiratory diseases and tuberculosis.
• Stroke
  • A Study reports a Positive correlation between smoking prevalence and stroke-related deaths.
• Lung Cancer
  • Study reports there is a higher likelihood of lung cancer with increased daily cigarette consumption.

Postpartum depression (PPD) is characterized by a major depressive episode that begins within four to six weeks following delivery, as per international diagnostic criteria. Recurrence rates for PPD are high, with 40% of affected women experiencing depression again in their lifetime and nearly 50% facing another episode in subsequent pregnancies. Symptoms of PPD encompass fatigue, irritability, anxiety, lack of pleasure, feelings of helplessness, sleep and appetite disturbances, indifference towards life events, low self-esteem, and feelings of incompetence as a parent, among others. PPD is considered a multifactorial condition influenced by both environmental and genetic risk factors for depression.

Risk factors for PPD  include:

• Previous depression.
• Adverse life events.
• Lack of social support.
• Socioeconomic position.
• Personal and family psychiatry history.
• Stressful experiences (such as trauma).
• Specific pregnancy-related factors.
• Intimate partner violence (IPV) occurring close to or during pregnancy also elevates the risk of postpartum depression.

The impacts of PPD are significant and extend beyond the affected individual. They include poor attachment between the mother and newborn, potential stunted growth and low weight in the child, disrupted breastfeeding, and adverse effects on the infant’s cognitive, emotional, and social development. There is also an increased risk for psychiatric disorders in the child during infancy, childhood, adolescence, and adulthood. Women of color and those with lower incomes are more likely to suffer from postpartum depression and may face barriers to accessing treatment (Gopalan et al., 202).

The four-stage process to regain control of Postpartum Depression

Women experiencing PPD often undergo a four-stage process in an attempt to regain control:

1. In the initial stage, mothers grapple with intense worries, persistent obsessive thoughts, and difficulties focusing.
2. In the second stage, women feel a sense of loss of their “regular selves,” describing a robotic feeling while caring for their infants. Withdrawal may occur, and thoughts of self-harm or suicide may surface.
3. The third stage involves women planning strategies to overcome PPD, such as seeking help from healthcare providers, engaging in prayer, or finding comfort in support groups.
4. In the final stage, women regain control of their thoughts and feelings as despair lifts.

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Stress has a significant impact on overall health, playing a crucial role in the development of various diseases and placing a substantial strain on the healthcare system (Shchaslyvyi et al., 2024). It is closely linked to numerous long-term health problems, especially cardiovascular conditions, which are often worsened by daily psychosocial pressures like job-related stress (Shchaslyvyi et al.,2024) It is essential to understand the healthy ways to cope with or manage stress.

Various strategies recommended according to the CDC (2025)

1. Take Care of Your Mind

Limit news and social media exposure: Excessive exposure to harmful or distressing news can exacerbate stress.

Make time to unwind: Incorporate relaxation practices such as deep breathing, stretching, or meditation.

Keep a journal: Writing can help you process emotions, reflect on your thoughts, and release tension.

Spend time outdoors: Whether you are being active (walking, hiking) or just relaxing outside, nature can be a calming presence.

Practice gratitude: Regularly noting things you are grateful for helps improve emotional well-being.

Connect with others: Talking to trusted friends, family, or community/faith-based groups provides support.

2. Take Care of Your Body

Get enough sleep: The CDC recommends 7 hours or more per night for adults and suggests maintaining a consistent sleep schedule.

Move more: Physical activity is one of the most effective ways to reduce stress; even small amounts can help.

Eat well: A balanced diet (fruits, vegetables, lean proteins, whole grains, low-fat dairy) supports both physical and mental health.

Limit alcohol and avoid substance misuse: Moderating alcohol intake, avoiding illegal drugs, and not misusing prescription medication are essential.

Avoid tobacco: Smoking, vaping, and the use of other tobacco products can worsen stress or its effects.

Stay up to date with healthcare: Regular check-ups, screenings, and vaccinations help you maintain your physical health — which can help buffer stress.

3. Integrate Physical and Mental Health

The CDC emphasizes that mental well-being and physical health are closely linked. Regular physical activity is not only good for the body but also supports emotional resilience.

It encourages finding a “right combination” of coping techniques that work for you — not everyone copes the same way.

4. Know When to Seek Extra Support

The CDC notes that while stress is everyday, chronic stress (long-term) can lead to serious health problems.

If you’re struggling to cope or stress is affecting your daily life, it’s okay to reach out for help. They list resources, including crisis lines.

Sources

CDC. (2025)

 International Journal of Environmental Research and Public Health, 21(8), 1077–1077. https://doi.org/10.3390/ijerph21081077