TOPIC ONE

MOLECULES, TRANSPORT AND HEALTH

1.1 THE DIPOLE NATURE OF WATER
● Water​ is a ​chemical​ compound consisting of two hydrogen atoms and an oxygen atom.
● Hydrogen atoms are partially positive while oxygen atom carries a negative charge.
● The opposite charges make water a polar substance.
● The separation of partially positive charge (hydrogen atom) and negative charge (oxygen atom)
results in the formation of ​hydrogen bonds​ between the water molecules.

IMPORTANCE OF WATER AS A SOLVENT IN TRANSPORT

● Water dissolves substances because of its ​dipole nature​.
● The polar molecules and ions e.g. NaCl interact with the partially positive and partially negative
ends of water.
● The Na​+​ ions are surrounded by the partially negative oxygen atoms and the Cl​-​ are attracted to
the partially positive hydrogen atoms.
● When there are many water molecules relative to solute, the interactions form a​ hydration shell
around the solute which disperses the particles evenly in water.
● The hydrogen bonds and cohesive forces between the water molecules make to flow thus
transporting dissolved substances.

BIOLOGICAL MOLECULES

● These are organic compounds that contain carbon, hydrogen and oxygen in their structures.
● They include carbohydrates, proteins and lipids.
CARBOHYDRATES

● These are the main source of energy for living organisms.

● They also form part of plant cell, fungi and bacterial cell walls
● Carbohydrates contain ​carbon, hydrogen and oxygen​ elements in their structure.
● They are divided into three main groups; ​monosaccharides, disaccharides ​and
polysaccharides.

MONOSACCHARIDES
● Monosaccharides have the general formula ​(CH​2​O)​n​ .(n is number of carbon atoms)
● They consist of single sugar molecule (simple sugars) e.g.
Triose sugars​ (n=3) with C​3​H​6​O​3​ formula.
Pentose sugars​ (n=5) with C​5​H​10​O​5​ formula e.g. ribose and deoxyribose.
Hexoses​ sugars (n=6) with C​6​H​12​O​6 e.g.
​ glucose, fructose and galactose.
● They dissolve in water to form a sweet tasting solution.

THE STRUCTURES OF MONOSACCHARIDES AND THEIR ROLES IN PROVIDING

ENERGY

● The molecular formula of ​hexose​ sugars is C​6​H​12​O​6​.

● The structural formulae show the arrangement of atoms in the ring structures of the
hexose sugars.
 Structures of glucose

Alpha (α) glucose Beta (β) glucose

Galactose Fructose

Relate the structure of monosaccharides to their roles.

● They have many ​carbon-hydrogen bonds​ which store lots of energy.
● The bonds are easily broken down to release energy which forms ATP
● Monosaccharides also form large molecules e.g. polysaccharides that include starch,
glycogen and cellulose.  

Formation of disaccharides
● These are sugars that consist of two monosaccharides joined together in their structure.
They include; maltose, ​copy the table on page 9.
● Have general molecular formulae ​C​nH ​ ​2n-2​O​n-1.
● They are formed by condensation reaction in which a hydroxyl group of one sugar
combines with the hydrogen atom in the hydroxyl group of the other sugar forming a
water molecule and glycosidic bond as below.

(a) Maltose formed when two α- glucose units link together

α- glucose + α- glucose Maltose

(b) Sucrose formed when α- glucose links with β-fructose

α- glucose + β-fructose Sucrose

(c) Lactose formed when α- glucose links with β-fructose

α- glucose + α- galactose Lactose + water

Polysaccharides
They are formed by many monosaccharides joined together in a condensation reaction.
They include;
i) Starch which is storage form of carbohydrates in plants
ii) Cellulose structural component in plant cell walls
iii) Glycogen which is a storage form of carbohydrates in animals.

Glycogen
(a) (i) Describe the structure of glycogen. (6BI01/J/2012) (​ 4)  
● Made up of many ​α- glucose units linked in a condensation reaction.
● The units are linked by ​joined by many 1,4 glycosidic bonds within the straight
chain and 1,6 in the side branches.
● It is highly branched structure
● It has a compact structure and insoluble in water.
(ii) Explain why it is a suitable molecule for storing energy 
● The many glycosidic bonds store lots of energy 
● The side branches are easily hydrolysed to release energy 
● Compactness allow more glucose to fit in smaller spaces in the cells. 
● Insolubility of glycogen has no osmotic effect in the cells.
 
Starch
● It is made up of many ​α- glucose joined by glycosidic bonds forming two polymers;
amylose and amylopectin.
● Amylose is a straight chain molecule that spirals and the glucose units are joined by only
1,4 glycosidic bonds.
● Amylopectin is highly branched and the glucose units joined by 1,4 and 1,6 glycosidic
bonds.
● Starch is compact to fit into a small space within the cells
● It is also not very soluble in water and therefore no osmotic effects in cell.
Reasons why it is a good source of energy
● Many glycosidic bonds that stores lots of energy
● Easily hydrolysed because of the side branches
● Compact to fit into small spaces
● No soluble in water hence no osmotic effect.
Lipids
● These are organic compounds found in plant and animal cells.
● They dissolve in organic solvents and not water.
● They contain carbon, hydrogen and relatively low oxygen atoms
● Fats are solids and oils are liquids at room temperature.
● Most lipids are triglycerides.
● Triglycerides are formed by condensing a glycerol molecule and three fatty acids.
a. A fatty acid is a molecule that has a long hydrocarbon chain and a carboxyl group at
one end (​R-COOH​).
b. A glycerol molecule has three carbon alcohol with three hydroxyl group (​C3​​ H​8​O​3​)
● An ester bond is formed between the carboxyl group (-COOH) of the fatty acid and the
hydroxyl group (-OH) of the of the glycerol molecule. This reaction is called esterification
● Also 3 molecules of water are released.
NB: living tissues contain more than 70 different types of fatty acids, which differ in two
ways.
a. The length of the hydrocarbon chain
b. Some are saturated and others are unsaturated
Differences between saturated and unsaturated lipids
Saturated fatty acids
● They are mainly found in animal fats
● Each carbon atom is joined to the next by a single covalent bond
● Each carbon atom is attached to at least two hydrogen atoms
● Has high proportion of hydrogens compared to unsaturated fatty acid.
Unsaturated fatty acids
● The carbon chains have one or more double covalent bonds carbon atoms
● The chain is said to be mono-saturated when it has a single double bond and
poly-saturated when it contains more than one carbon – carbon double bond.

Class work
(i) The diagram below shows the structure of a galactose molecule and a 
glucose molecule. 
(i) In the space below, draw a diagram to show the products formed when these 
two molecules join together to form lactose. 
(3) 
 
 
 
 
 
 
 
(ii) Name the chemical reaction that joins the galactose and glucose molecules 
together. (​ 1) 
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(iii) Name the bond that joins the galactose and glucose molecules together. 
(1) 
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(6BI01/M/2011) 
(a) Distinguish between the structures of each of the following pairs of carbohydrate
molecules.
(i) Monosaccharides and disaccharides ​(2)
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(ii) Amylose and amylopectin ​(2)
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(b) Explain why a diet consisting of a high proportion of carbohydrates could lead to
obesity. ​(2)
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(Total for Question 2 = 6 marks)

THE MAMMALIAN MASS TRANSPORT SYSTEM

● Mass transport system is an arrangement of structures by which substances are
transported in the flow of a fluid with mechanisms for moving it around the body.
● It consists of the heart, circulatory system and the fluid that flows through it.
Why animals need the mass transport system
● To overcome, limitations of diffusion because the surface area in contact with the
environment is small compared to volume.
● To transport, useful substances from specialised exchange sites i.e lungs and small
intestines to tissues.
● To remove wastes such as CO​2​ and urea as rapidly as they are formed from the body
cells.
Features of the mass transport system
● Exchange surfaces to get materials into and out of the transport system.
● A system of vessels that carry substances
● Substances move faster in the right direction that nutrients in and wastes out.
● A suitable transport medium e.g. fluid

Circulatory systems
● It consists of the heart, blood vessels and blood
● Insects have open circulatory system with blood flowing through large open spaces.
● Large animals e.g. mammals have a closed circulatory system with blood contained
within tubes.
Advantages of closed system
● The pressure can be increased to make the blood flow more quickly.
● The flow can be directed more precisely to the organs that need most oxygen and
nutrients.
Types of closed circulatory systems
(​i) Single circulatory system e.g. in fish
● Blood passes only once through the heart per complete circulation.
● Heart has two chambers, blood is pumped by the ventricle the gills for oxygenation
and then flows to the rest of the body.
● Deoxygenated blood always mix with oxygenated blood.
Double circulatory system e.g. in mammals and birds
● Blood passes twice through the heart.
● It consist of pulmonary and systemic circulations
● Pulmonary circulation that carries deoxygenated blood from the heart to the lungs for
oxygenation and then back to the heart.
● Systemic circulation that carries oxygenated blood to the body cells and
deoxygenated blood back to the heart.
Advantages of double circulatory system
● Oxygenated and deoxygenated blood do not mix so tissues receive as much oxygen
as possible.
● Separation of pressures, oxygenated blood delivered to tissues at higher pressure
and more quickly while blood flows at a relatively low pressure to the lungs to avoid
damage to the delicate blood capillaries and allow gas exchange.

The structures of blood vessels and how they relate to their functions
(i) Arteries
They oxygenated blood away from the heart and towards body cells at high pressure
except.
i) Pulmonary artery – carries deoxygenated blood from the heart to the lungs.
ii) Umbilical artery – carries deoxygenated blood from the foetus to the placenta.
● The wall of the artery is thick to withstand the high blood pressure and prevent
bursting of the vessel. It has three layers with a narrow lumen that maintains the
pressure as blood flows.
● The inner endothelial lining called tunica intima is composed of flattened layer
squamous epithelial cells which is very smooth minimizing friction.
● The middle layer called tunica media contains smooth muscles and elastic fibres
which stretch and recoil to accommodate various pressures.
● The outer layer called tunica externa consists of elastic fibres and collagen fibres.

Veins
Most veins carry deoxygenated blood from body tissues back to the heart, except;
i) Pulmonary vein – carries oxygenated blood from the lungs back to the heart.
ii) Umbilical vein – carries oxygenated blood from the placenta to the fetus.
The blood is returned to the heart by muscle pressure exerted on the veins, thus
squeezing them and the one way-valve.
● They have the same three layers as arteries, but the tunica media is much thinner and has
far fewer elastic fibres and muscle fibres
● They have a large lumen
● They have semi-lunar valves at intervals.
Capillaries
● These are very small vessels that spread throughout the tissues of the body and form the
exchange sites for materials between body cells and the blood.
● Their walls are one cell thick and contain no elastic, smooth muscles or collagen.
● The presence of pores allows faster diffusion of substance e.g. amino acids and glucose.

Mammalian Heart
● The wall is made up of the cardiac muscle that does not get fatigued.
● It is divided into the left and right sides by a septum so that oxygenated blood in the left
does not mix with deoxygenated in the right side.
● It is further divided into four chambers by atrioventricular valves. The lower chambers are
called ventricles and the upper are called atria.
● Tricuspid valve has three flaps. It separates the right atrium from the right ventricle. It
opens when the atrium is fully is contracting to allow blood enter the right ventricle and
closes when the right ventricle contracts.
● Bicuspid valve has two flaps. It separates the left atrium from the left ventricle. It opens
when the left atrium contracts and closes when the left ventricle contracts.
● The valves are supported by tendons which prevent valves from turning inside out by the
pressure exerted when the ventricles contract.
● The semi-lunar valves are located at the junction of the aorta and pulmonary artery.
● Valves prevent the back flow of blood and allow one directional flow.
● The wall of the left ventricle is thicker than the right ventricle. It has to produce sufficient
pressure to move blood around the body. The right ventricle pumps blood to the lungs that
have delicate blood capillaries and a shorter distance.
The cardiac cycle
● It is a cycle of contraction (systole) and relaxation (diastole) of the atria and ventricles that
keeps the blood circulating around the body.
● Systole and diastole cause the pressure and volume of the chambers to change.
● The cycle can be divided into three stages
(a) Atrial systole
● Both atria contract at the same time, while ventricles relax.
● The volume of the atrial chambers decreases while the pressure increases.
● Atrioventricular valves open and blood enter the ventricles.
● Semi-lunar valves at the base of the aorta and pulmonary artery close.

(b) Ventricular systole

● Ventricles contract at the same time, while atria relax.
● The volumes of the ventricles decrease while the pressure increases.
● Atrioventricular valves close preventing blood entering the atria.
● Semi-lunar valves open due to the high pressure letting blood to enter the aorta and
pulmonary artery.
(c) Diastole
● Ventricles and atria relax for a short time.
● The higher blood pressure in the aorta and pulmonary artery causes the semi-lunar valves
to close.
● Atria fill again due to the higher pressure in the vena cava and the pulmonary vein and the
cycle starts again.
3 ​Many animals, such as mammals, have a heart and circulation. This helps them 
to meet their requirements by overcoming the limitations of diffusion. 
*(a) Describe the structure of the mammalian heart. (​ 5) 
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(b) Giraffes are very tall mammals found roaming the plains of Africa. 
Two giraffes are shown in the photograph below. 
Using the information in the photograph and your own knowledge, explain the 
importance of the heart and circulation to the giraffe. 
(4) 
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(Total for Question 3 = 9 marks) (6BIO1/01/may2012) 
3 ​The cardiac cycle involves the contraction and relaxation of heart muscle. This 
brings about changes in blood pressure within the heart. 
(a) The table below refers to the three phases of the cardiac cycle. Complete the 
table by stating whether the atria and ventricles are c
​ ontracted ​or r​ elaxed ​in 
each 
of these three phases. 
(b) Describe the roles of the atrioventricular (bicuspid and tricuspid) valves 
during the 
cardiac cycle. 
(4) 
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(c) The graph below shows changes in the blood pressure in the aorta and the 
left 
ventricle during two complete cardiac cycles. 

(i) Use the information in the graph to calculate the heart rate. Show your 
working. (​ 3) 
 
 
 
 
Answer .​ ............................................................ 
(ii) During the cardiac cycle, the pressure in the right ventricle rises to a 
maximum of about 3.3 kPa. Suggest reasons for the difference between this 
pressure and the maximum pressure in the left ventricle, as shown in the 
graph. 
(3) 
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(Total for Question 3 = 13 marks) 

Haemoglobin
● This is a red pigment in a red blood cell (erythrocyte)
● It is a large globular protein made up of four polypeptide chains, each with an iron
containing prosthetic group called haem.
● Each group combines with one molecule of oxygen and therefore, a total of four
oxygen molecules are carried by one molecule of haemoglobin.
● This forms oxyhaemoglobin which is unstable and dissociates easily, releasing the
oxygen to the body cell.

Hb + 4O2​ ​ Hb.4O​2
Haemoglobin + oxygen oxy-haemoglobin

● When the first O​2​ binds to the haemoglobin, it changes the arrangement of the
molecule making it easier for the subsequent molecules to bind.

Oxygen dissociation curve of haemoglobin

● There is a higher concentration or partial pressure of oxygen in the lungs compared

to other body tissue.
● The red blood cells entering the lung capillaries have low concentration of oxygen
than the alveoli, hence a steep diffusing gradient exist.
● More oxygen diffuses into the red blood cell and combines with haemoglobin to about
97% saturation (all haemoglobin combines with four molecules of oxygen)
● In the body tissues and actively respiring cells, the concentration or partial pressure
of oxygen is relatively low. Therefore, the haemoglobin coming from the lungs carries
a lot of oxygen, releases about 75% of it.
● The oxygen then diffuses into the body cells to be used for respiration.

● The shape of the haemoglobin dissociation curve reflects the way that oxygen atoms combine
with haemoglobin molecules.
● Up to oxygen partial pressure of around 2 kPa, on average only one oxygen molecule is
combined with each haemoglobin molecule.
● Once this oxygen molecule is combined, however, it becomes successively easier for the second
and third oxygen molecules to combine, so the curve rises very steeply.
● Over this part of the curve, a small change in the partial pressure of oxygen causes a very large
change in the amount of oxygen which is carried by the haemoglobin.
Transport of Carbon Dioxide
● Respiring cells release CO​2​ via diffusion into the blood plasma.
● Some CO​2​ Slowly reacts with water in plasma to form carbonic acid.
● Other molecules of CO​2​ diffuse into the cytoplasm of the red blood cells in which carbonic
anhydrase enzyme catalyses the formation of carbonic acid.
● Carbonic acid readily dissociates to form hydrogen-carbonate ions and hydrogen ions
● About 85% of the ​hydrogen-carbonate ions diffuse out of the red blood cell into the plasma
where they are carried in solution.
● Some CO​2 ​does not dissociate but remain as molecules, so tit dissolves in plasma and about 5%
is transported this way to the lungs.
● Other CO​2​ diffuse into the red blood cells and combine directly with a terminal amine group of
haemoglobin to form ​carbaminohaemoglobin​, hence 10% of CO​2​ is carried this way.
The Bohr Effect
● It involves the changes in the oxygen dissociation curve as a result of changes in the partial
pressures of carbon dioxide.
● The absorption and release of oxygen by haemoglobin is affected by the proportion or
partial pressure of CO​2​ in tissues.
● High partial pressure of carbon dioxide in tissues reduces the affinity of haemoglobin for
oxygen and causes it to release oxygen.
● Carbon dioxide concentration in the lung capillaries are relatively low, which makes it easier
for oxygen to bind to the haemoglobin.

FETAL HAEMOGLOBIN
● The blood of the foetus has a special oxygen carrying pigment called foetal haemoglobin
which has a higher affinity for oxygen than the adult haemoglobin of the mother.
● It can remove oxygen from maternal blood even when the proportion of oxygen is relatively
low.
● The maternal blood and fetal blood also run in opposite directions. This makes the oxygen
gradient between the mother’s blood and the fetus as steep as possible, maximising the
oxygen transfer to the blood of the fetus.

Events that leads to atherosclerosis

● Atherosclerosis is hardening of the arteries due to the build-up plaques (a yellowish
fatty deposit) on the inside of arteries.
● Atherosclerosis starts when the endothelial lining of arteries is damaged by high
blood pressure or substances in tobacco smoke.
● The body’s inflammatory response begins and the white blood cells arrive at the
damaged site.
● The cells accumulate chemicals from the blood including cholesterol that leads to the
formation of the plaque/ atheroma
● Overtime, more lipids, fibrous tissue and calcium salts build up around the atheroma
causing it to harden.
● Hardening of the atheroma makes part of the artery to lose its elasticity and the
lumen becomes narrower.
● This restricts blood flow, forcing the heart to pump harder and further increasing the
blood pressure which causes more damage to the endothelial lining.
● The plaque continues to grow and block the lumen of the artery leading to
cardiovascular diseases.
● It prevents excessive bleeding and prevents entry of pathogens through the open
wound.

Blood clotting process

● The process occurs when blood vessels get damaged.
● Platelets rapture releasing serotonin and thromboplastin.
● Serotonin causes the smooth muscles of the blood vessel to contract, narrowing the
lumen of the vessel hence restricting the blood flow.
● Thromboplastin, catalyses the conversion of a soluble protein called prothrombin into
thrombin which is an active enzyme in presence of calcium ions and vitamin K.
● Thrombin converts another soluble protein called fibrinogen into fibrin which forms a
mesh that covers the wound.
● More platelets and red blood cells from the wound get trapped in the mesh to form a
clot which then contracts and dries to form a scab.

Role of blood clots in cardiovascular diseases.

● Blood clotting process may be triggered when platelets touch hardened surfaces of
the plaques or the damaged endothelial lining.
● Blood clots called thrombus are formed in the main blood vessels such as the
coronary artery and carotid artery leading to heart disease and strokes.

Heart disease
● The most common heart diseases include; angina and myocardial infarction that are
linked to atherosclerosis.
● Angina, result from plaques that build up slowly in the coronary artery, reducing
blood flow to parts of the heart muscle. The muscle respires anaerobically due to
insufficient supply of oxygen.
● This leads to a gripping pain in the chest that spreads to the left arm and the jaw
also breathlessness during exercise.
● If the coronary artery is completely blocked by the blood clot, oxygenated blood and
nutrients are restricted to the muscle.
● The Part of the muscle served by the vessels die and this leads to heart attack.
● Severe chest pains are experienced at any time and may lead to death.

Strokes
● Stroke is the rapid loss of brain function due to the interruption of normal blood flow
to the brain.
● It is caused by a thrombus in the carotid artery that supplies the brain.
● Oxygen and nutrients do not reach the brain, so the brain cells starts to die.
● The symptoms include; dizziness, confusion, slurred speech, blurred vision,
numbness and paralysis.
Risk factors for CVDs
A range of factors have been identified and are divided into two categories;

1. Non-modifiable risk factors

a) Genes-​ Some families inherit particular alleles that make them more likely to
develop:
- Arteries which are easily damaged.
- High blood pressure (hypertension)
- Problems with cholesterol balance of the body (faulty cholesterol metabolism)
b) Age​ – the risk increases with age because arteries lose their elasticity and narrows
slightly.
c) Gender​- men are more likely to suffer from CVDs than pre-menopause women. The
oestrogen hormone reduces the build-up of plaques in females. This gives the women
some protection against CVDs.

2. Modifiable (lifestyle) risk factors

a) Smoking –​ it contains chemicals e.g. Carbon monoxide, nicotine and other
chemicals.
The chemicals damage the endothelial lining of the artery, which triggers the build-up
plaques.
Nicotine makes platelets to stick together forming blood clots and plaques. The arteries
become narrow, raising the blood pressure and this increases the risk of atherosclerosis.
Studies have revealed that smokers are more likely to develop atherosclerosis than non-
smokers with a similar lifestyle. Similarly there is a correlation between smoking and the
incidence of death from atherosclerotic heart disease.
b) Inactivity –​ high levels of inactivity is linked to obesity, diabetes, high blood
pressure and CVDs.
Regular exercise lowers blood pressure, prevents the formation of plaques and obese
condition. Blood cholesterol, lipoproteins are balanced and also reduces stress.
c) High blood pressure - ​it is closely linked to stress, diet and excessive alcohol
consumption. It increases the risk of damaging the endothelial lining of the arteries and
the formation of plaques or atheroma. It leads to the development of atherosclerosis
because the arteries are less flexible and narrowing of their lumen.
d) Diet and obesity -​ a diet high in saturated fats, increases the levels of cholesterol in
the blood, hence greater chance to develop thrombus. This restricts the blood flow,
leading to increased blood pressure and damage of the endothelial lining.

Link between dietary antioxidants and the risk of CVDs

● Antioxidants are molecules that inhibit the oxidation of other molecules which can
lead to chain reactions that may damage cells e.g. vitamin A, C and E.
● Different studies have shown conflicting results. Some results that antioxidants
protect the heart and others give evidence that some antioxidants may cause harm.
Vitamin C case study
● Vitamin C is needed for the formation of connective tissues e.g. endothelial lining of
blood vessels, skin etc.
● Severe lack of Vitamin C in the diet causes scurvy and the lining of the artery is
easily damaged hence atherosclerosis is more likely to develop and other related
CVDs.
● Some studies have revealed a strong correlation between the concentration of
vitamin C in the blood and the risk of heart attack in men.
● High incidences of heart attack occur in people with very low concentrations of
vitamin C compared to those with no vitamin C deficiency.
● On the contrary, some work has shown that there is no correlation between Vitamin
C and heart health. The study published in international journal of molecular sciences
showed that taking vitamin C could damage heart health, hence contradictory
evidence
Investigate the vitamin C content of food and drink.
● Vitamin C is tested using a deep blue reagent called DCPIP (2,6 – dichlorophenol - indophenol)
● About 25ml of DCPIP is pipetted into a conical flask.
● The burette is filled with the fruit juice extract.
● The juice is titrated against the DCPIP.
● The volume of the juice that discolours the DCPIP is recorded.
● The concentration of vitamin C in each fruit juice can be estimated by comparing with the
standard.

Data analysis and interpretation on illness and mortality rates to determine

health risks
Studies are usually carried out and the information is given in form of data.
Data ​is a collection of values or measurements of the independent and dependent
variables.
Data interpretation involves:
● reading and describing charts or graphs
● Describing the relationship between the variables eg. Positive, negative or no
correlation.
● draw conclusions
● Comment on reliability
Correlation – relationship between two variables such that a change in one of the variables is
reflected by a change in the other variable that is ​when an increase in one thing is
accompanied by an increase in another (positive). ​For example, mortality data from a disease
such as atherosclerosis may change in a similar pattern to a lifestyle factor such as smoking or
lack of exercise.
Causation - ​when a change in one variable is responsible for a change in another variable
e.g. its not the length of the TV programme but the fact that they did not get enough sleep
which accounts for the percentage of children asleep).

Link between blood cholesterol and CVDs

Studies have shown that there is a correlation between high intake of saturated fats, high
blood cholesterol levels and increased risk of CVDs.

*GRAPH*u

Similarly there is a clear correlation between LDL to HDLs ratio and deaths from CVDs. A
healthy ratio should be 3:1. The balance of the lipo-proteins in the blood is an indication of
the risk of developing atherosclerosis and hence a CVD.

*GRAPH*

Causal link between blood cholesterol and CVDs

Eating foods rich in saturate fats increases the amount o cholesterol in blood.high
cholesterol levels more than 251 – 300 mg/100cm3 of blood accelerates atherosclerosis and
hence the risk of developing CVDs.
Example

Cardiovascular disease (CVD) is a major cause of death in developed countries.

(a) The table below shows male death rates from CVD in several developed
countries.

(i) Suggest why the data are presented as deaths per 100000. (​ 1) 
Different countries have different population sizes / number of people in each
country may differ ;
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(ii) In France, 48 000 men died from CVD in 2011. The male population of 
France was 31000000. Calculate the death rate from CVD per 100 000 males 
in France. ​Show your working. (​ 2) 
48 000 ÷ 31 000 000 ;
= 155 ; d
​ eaths per 100 000 
(iii) Suggest reasons for the different death rates from CVD in Italy and 
Romania. (​ 3) 
1. There is greater genetic difference between the people ;
2. They have different dietary intake and other lifestyles
3. The population sampled had different age profiles
6. Difference in healthcare and availability of drugs and other precautionary
measures.
Explain why the combination of a high-fat diet and low activity levels may 
lead to 
CVD. 
High intake of saturated fats increases the blood cholesterol and therefore the 
ratio of LDL to HDLs is very high.fats 
1. there is energy imbalance and individual becoming {​overweight ​/ ​obese /​ eq } ;
3. idea of increased ​blood pressure ;​
Obesity ​leads to ​diabetes ​(a CVD risk factor) or increased (blood) {​cholesterol / LDL
levels / LDL to HDL ratio}​ ;
This damages to ​endothelium ​/ overloading of ​receptors​} hence formation of {
atheroma / plaque /atherosclerosis } ​and {loss of elasticity of ​artery /​ narrowing
of ​lumen ​/ eq } ; 
Smoking and CVDs

Studies have shown that there is a correlation between the smoking and CVDs. Smokers are
far more likely to develop atherosclerosis than non-smokers with a similar lifestyle. Nicotine
is the causative agent of atheroscelerosis.

Graph on page 57

The causation

Blood Cholesterol and CVDs

• Cholesterol is a lipid which is not good for human body; it is made from saturated
fats. For the movement of cholesterol, it should attach to a protein molecule and
forms lipoproteins.
• There are two types of lipoproteins:
1. ​High Density Lipoproteins (HDLs): ​are made from unsaturated fats, cholesterol
and protein. They transport cholesterol from body tissue to the liver to be broken
down, thus reduce the level of cholesterol in blood. HDLs can also help to remove
cholesterol from plaques on the arteries which reduce the risk of atherosclerosis.
2. ​Low Density Lipoproteins (LDLs): ​are made from saturated fats, cholesterol and
proteins. They bind to cell membranes before being taken the cells. If there are high
of LDLs, the cell membranes will be saturated and so more LDL cholesterol remains
in the blood. LDLs also transport cholesterol from the liver to the blood. These
increase the blood cholesterol High levels of HDL and cholesterol increase the
chances of CVDs.

Class work
(b) A stroke can be caused by cardiovascular disease (CVD) affecting arteries 
leading to the brain. Callum’s family has a history of strokes. 
(i) Explain why a blood clot in an artery leading to the brain could cause a stroke. 
(3) 
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(ii) Suggest ​two l​ ifestyle changes Callum could make to reduce his risk of 
suffering a stroke in later life. 
(2) 
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(6BIO1/01R may 2013) 
 

 
 
(b) (i) Suggest how the location of the atheroma results in the position and size 
of this region of dead heart muscle. (​ 3) 
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There is evidence for a causal relationship between blood cholesterol levels and 
cardiovascular disease (CVD). 
(a) Explain the meaning of the term ​causal relationship​. 
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(c) Obesity and high blood pressure are also factors that increase the risk of 
CVD. 
The graph below shows the percentage of people with CVD who have high blood 
pressure or have high blood cholesterol or are obese for the period 1960 to 
1990. 
 
 
 
(i) Using the information in the graph, describe the overall changes that have 
occurred in these risk factors during this period. 
(3) 
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(ii) Suggest ​two r​ easons for the overall change in high blood cholesterol as a risk 
factor. (​ 2) 
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(iii) State two factors, other than obesity, high blood pressure and high 
blood cholesterol, that increase the risk of CVD. (​ 1) 
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(6BIO1/01 JAN 2013)
5 ​Asim has been warned by his doctor that he is at an increased risk of cardiovascular
disease (CVD) because of his current high-fat diet and low activity levels.
*(a) Explain why the combination of a high-fat diet and low activity levels may lead to
CVD. ​(5)
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(WBI01/01/JAN 2014) 
 
 

use of scientific knowledge on risk factors to reduce incidences of CVDs

● the results from the studies about the risk factors of CVD can be used to sensitize
people to change their lifestyle with the aim of reducing CVDs.
Information on diet
● Encourage people to reduce fat intake because diet rich in saturated fats increases
the amount of LDLs
Obesity indicators
● BMI and waist to hip ratio can be used to assess whether people are
overweight/obese. An individual can make a choice to reduce his or her weight by
exercising or dieting.
Smoking
● They are warning on cigarette packets to discourage people from smoking.
Exercise
● Campaigns have been intensified to encourage people to exercise to increase the
energy output and to reduce cholesterol levels in the blood.

Perception of Risk
● Risk is the probability or chance of something unfavourable happening.
● Person’s perception on risk is based on a variety of factors such as
● How familiar you are with the activity
● How much you enjoy the activity.
● Whether or not you approve the activity
● Some people overestimate the risk- believe things to be of greater risk than they actually are
e.g. there is a strong that obesity is linked to a range of disease such as diabetes,
cardiovascular disease and some cancers.
● Some people underestimate the risk- things have a lower risk than they are. This could be
due to lack of knowledge making them unware of the factors that contribute to diseases like
CVDs.

Evaluating designs of scientific study

The study of patterns of diseases and there causes is called epidemiology.
Most of the epidemiological studies are based on very big sample size to have meaningful data.
When a large number of people are studied, it is more likely that a pattern may emerge
Evidence based on large amounts of data is more likely to be statistically significant than
evidence based on small studies.
Longitudinal studies are carried out over a long period of time and are very valuable because
they follow the same group of individuals over many years.
Factors to consider include the
a. Sample size – the bigger the sample size the more reliable the results are
b. Validity- means that your findings truly represent the phenomenon you are claiming to
measure. It also involves examining the methodology to see if it is properly designed to
answer the question being investigated.
c. Sample selection - the sample should be representative of the whole population to avoid
bias.
d. Variables – other factors that might affect the result must be controlled to increase
validity
e. Repetition – this increases the reliability of the result of the results. To ensure that our
results are more valid, we make a comparison with other scientists who have used the
same methodology and if they are similar, the results/conclusion is valid.

Treatments for cardiovascular disease (CVD)

Antihypertensive drugs
● This are drugs that reduce the blood pressure.
● Diuretics that increase the volume of the urine produced. This eliminates the
fluids and salts so that the blood volume decreases. With less blood, a smaller
volume is pumped from the heart and the blood pressure falls
● Beta blockers interfere with the normal system for controlling the heart. They
block the response of the heart to hormones such as adrenaline, which normally
act to increase the blood pressure. They make the heart rate slower and the
contractions are less strong, so the blood pressure is lower.
● Sympathetic nerve inhibitors affect the sympathetic nerves which stimulate
arteries to constricts, which raises the blood pressure. The inhibitors prevent the
nerves signalling to the arteries, which helps to keep the arteries dilated and
blood pressure is lowered.

● ACE inhibitors​ block the production of angiotensin which is a hormone that

stimulates the constriction of blood vessels and so causes blood pressure to rise.
● The inhibitor .
● They reduce the blood pressure and hence the risk of CVDs
Benefits of antihypertensive
● They reduce the risk of CVDs
● They reduce the risk of damage to the kidneys and eyes from high blood
pressure
Risks
● If the treatment is not monitored, the pressure may be too low leading to falls and
injuries
● Coughs,
● Swellings of the ankles
● Impotence
● Tiredness and fatigue
● constipation
Statins
● This is a group of drugs that reduce blood cholesterol by
● Reducing the amount of cholesterol absorbed from the gut
● Blocking the enzyme in the liver that is responsible for making LDLs (bad
cholesterol)
● They improve the balance of LDLs to HDls
● Reduce inflammation in the lining of arteries
Benefits
● Lower levels of cholesterol reduces atheroma formation which in turn reduces the
risk of CVDs
Risk
● They can reduce the absorption of some vitamins from the gut
● Muscle and joint aches
● Nausea
● Constipation and diarrhoea
● Muscle inflammation rave
● Liver problems
Anticoagulants
● These are drugs given to prevent the formation of blood clots following a surgery
or after suffering from a blood clot/thrombus
● Warfarin​ is an anticoagulant that interferes with the manufacture of prothrombin
in the body.
● Less prothrombin levels, make the blood clot less easily

● Platelet inhibitory​ drugs e.g aspirin and clopidogrel make platelets less sticky,
and so reduce the clotting ability of the blood.
● A combination of aspirin and clopidogrel can reduce the risk of developing a
range of CVDs by 20-25% in some low risk patients.
Benefits
● Prevent development of new blood clots
● Can be used to treat people who have blood clots
● Reduce the risk of developing a range of CVDs by 20-25% in some low risk
patients.
Risks
● Irritates the stomach lining
● causes bleeding in the stomachs
● liver dysfunctions
● rushes on the body
● nausea