Professional Documents
Culture Documents
1. 2020 Jan Q6
6 A diet high in salt has been shown to increase the risk of some diseases.
The graph shows the results of one study into the increased risk of death related to a
0.50
0.25
(a) State two conclusions that can be drawn from these results.
(2)
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*P60516RA01628*
(b) The values for the hazard ratio were adjusted for a number of factors, including
age and smoking.
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(i) Explain why age and smoking were taken into account when determining the
hazard ratio.
(3)
(ii) State two factors, other than age and smoking, that may have been considered
when adjusting the values for the hazard ratio.
(2)
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(c) Suggest why the hazard ratio for low salt intake was 1.00 for each cause of death.
(2)
(d) (i) The results of this study suggest that there is a correlation between salt intake
and cause of death.
State the meaning of the term correlation.
(1)
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2. 2019 Oct Q1 Answer ALL questions.
Some questions must be answered with a cross in a box . If you change your mind about an
answer, put a line through the box and then mark your new answer with a cross .
1 The graph shows the relative risk of developing cardiovascular disease (CVD) for
non-smokers and for smokers.
6
Key
0
25–34 35–44 45 and above
Age / years
(a) (i) Describe the conclusions that can be made about the risk factors for CVD.
Use the information in the graph to support your answer.
(2)
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(ii) The information shown in this graph was collected more than 25 years ago.
Explain how this graph might appear if it showed data collected last year.
(2)
(b) The number of people in the world who die from CVD each year is 17.7 million.
This is 31% of all total deaths.
How many deaths are there in the world each year?
(1)
A 0.571 × 106
B 5.71 × 106
C 57.1 × 106
D 571.00 × 106
(a) A diet high in saturated triglycerides raises the levels of cholesterol in the blood.
(i) What is the ratio of glycerol to fatty acid in a triglyceride molecule?
(1)
A 1:1
B 1:3
C 3:1
D 3:3
(ii) Which diagram shows the bond that joins a glycerol molecule to a fatty acid in
a triglyceride?
A C N C
H OH
B C N C
O
C C O C
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OH
D C O C
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(iii) The table gives some information about four fatty acids.
Number of double bonds
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Explain which of these fatty acids would have the lowest risk of causing CVD,
if included in a diet in equal masses.
(2)
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(b) Anticoagulants, antiplatelets and thrombolytics are drugs used to treat blood clots.
(i) One anticoagulant binds to the active site of thrombin.
(ii) Molecules on the surface of platelets enable them to bind to other molecules.
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(iii) One thrombolytic drug converts plasminogen into the active enzyme, plasmin.
Plasmin breaks down fibrin.
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4. 2019 Jan Q2
2 The diagram shows a coronary heart disease (CHD) risk calculator.
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(b) Explain why the risk calculator takes into account total cholesterol and
HDL cholesterol levels.
(2)
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(c) Explain why the 10 Year CHD Risk would change if this person ticked the box next
to the ‘Patient smokes’ on the risk calculator.
(3)
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(ii) Predict the effect that taking this factor into account would have on the value
for the 10 Year CHD Risk.
(1)
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5. 2018 Jan Q3
3 Lipids are transported in the blood as lipoproteins.
(a) The table below shows some information about lipoproteins.
Put a cross ( ) in the box that completes each of the following sentences.
(i) The density of lipoproteins is inversely proportional to the percentage of
(1)
A cholesterol
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(b) The table below shows the incidence of cardiovascular disease (CVD) for groups of
people with different blood cholesterol concentrations and systolic blood pressures.
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(i) Using the information in the table, describe the relationship between systolic
blood pressure, blood cholesterol concentration and the incidence of CVD.
(3)
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(ii) High blood pressure may cause atherosclerosis.
Describe how the development of atherosclerosis can result in CVD.
(iii) Suggest two treatments for the group of people with the greatest risk of CVD.
Give one risk for each treatment.
(4)
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6. 2017 Jun Q4
4 The addition of sugars to food is one risk factor for cardiovascular disease (CVD).
(a) Two sources of sugar used in foods are sucrose and high fructose corn syrup.
‑
(i) Describe how sucrose is formed from monosaccharides.
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(3)
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(b) There may be a relationship between added sugar in the diet and the ratio of
LDL cholesterol to HDL cholesterol in the blood.
‑
‑
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1.8 –
to HDL-cholesterol
1.7 –
1.6 –
1.5 –
1.4 –
–
–
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(i) The scientist who carried out this study concluded that:
‘The addition of large quantities of sugar in the diet increases the risk of CVD.’
Use the information in the graph and your own knowledge to explain why the
scientist came to this conclusion.
(3)
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(ii) Suggest two reasons why the young people included in this study might
underestimate the risks of added sugar in their diet.
(2)
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(iii) Suggest why young people taking statins were not included in this study.
(2)
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7. 2017 Jan Q2
2 Cardiovascular disease (CVD) is a major health problem in both developing and
developed countries.
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20
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(c) A clinical trial was carried out to investigate the effect of reducing blood pressure
on the risk of suffering a heart attack or stroke.
(ii) Suggest why this clinical trial did not include a placebo.
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8. 2016 Oct Q3
3 Obesity is a risk factor in the development of cardiovascular disease (CVD).
(a) Pima Indians living in Arizona are genetically very similar to those living in Mexico.
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The table below shows the frequency of obesity in Pima Indians in these two locations.
Location of Frequency of
Pima Indians obesity (%)
Arizona 30
Mexico 13
(i) Suggest why there is a higher frequency of obesity in Pima Indians living in
Arizona than in Pima Indians living in Mexico.
(2)
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(ii) Scientists are studying Pima Indians to investigate the causes of CVD.
State two risk factors, other than obesity and genetic factors, associated with
developing CVD.
(2)
1
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(b) Body mass index (BMI) is one way of identifying individuals that are overweight or obese.
BMI is calculated using the formula below.
BMI Classification
(c) The results of a different study on the relationship between CVD and body mass
index are shown in the graph below.
300 –
250 –
Incidence of CVD per
1000 individuals
200 –
Men
150 –
Women
100 –
50 –
0–
–
24
(i) Using the information in the graph, describe the relationship between body
mass index and the incidence of CVD.
(2)
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9. 2016 Jun Q4
4 Atherosclerosis is a major risk factor for cardiovascular disease (CVD).
(a) Put a cross in the box that completes each of the following statements.
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(i) Atherosclerosis develops in
(1)
A arteries
B capillaries
C chambers of the heart
D veins
(ii) Atherosclerosis starts with
(1)
A an inflammatory response in blood vessels
B damage to the endothelial layer of blood vessels
C decreased blood pressure
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D plaque formation in blood vessels
(b) Atherosclerosis leads to an increased risk of blood clotting.
(i) Describe the blood clotting process.
(4)
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(ii) Name two treatments that can reduce the risk of blood clots forming.
(2)
17.5
17.0
16.5
None Beetroot Garlic
Food supplement
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*P46641A01024*
(i) Using the information in the graph, describe the effect of eating beetroot and
garlic on blood pressure.
(2)
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(ii) Suggest two ways in which the design of this study could be improved.
(2)
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10. 2016 Jan Q3
3 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)
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(ii) In France, 48 000 men died from CVD in 2011. The male population of France
was 31000 000.
Calculate the death rate from CVD per 100 000 males in France.
Show your working.
(2)
29
(iii) Suggest reasons for the different death rates from CVD in Italy and Romania.
(3)
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11. 2015 Jun Q4
4 High blood pressure is a factor that increases the risk of cardiovascular disease (CVD).
The graph below shows the effects of diastolic blood pressure and systolic blood
pressure on CVD death rate.
>13.2
12.0–13.2 >21.2
10.7–11.9 18.6–21.2
10.0–10.6 16.0–18.5
9.3–9.9
Diastolic blood <16.0 Systolic blood
pressure / kPa
<9.3 pressure / kPa
(a) Using the information in the graph, describe the effects of diastolic blood
pressure and systolic blood pressure on CVD death rate.
(3)
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1 . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . .. . . . . . . . . . . . . . . . . .
2 . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . .. . . . . . . . . . . . . . . . . .
(d) Place a cross in the box next to the type of drug used to treat high blood
pressure.
(1)
A anticoagulant
B antihypertensive
C plant statin
D platelet inhibitor
*P44869A01020* 32
12. 2015 Jan Q3
3 Atherosclerosis is a potentially serious condition that affects millions of people each year.
There is a link between saturated fats in the diet and atherosclerosis.
(a) Read through the passage on atherosclerosis, then write on the dotted lines the
most appropriate words to complete the passage.
(5)
to the tissues. This can cause a heart attack or, if the ..........................................................
(b) It has been suggested that high blood cholesterol levels can cause cardiovascular
disease (CVD). Coronary heart disease is one type of CVD.
The graph below shows the relationship between mean blood cholesterol level
and the risk of death from coronary heart disease in two groups of people.
1.5
People living
Risk of death from coronary heart
and New
1.3
Zealand
1.2
1.1
1.0
0.9
0.8
4.5 5.0 5.5 6.0 6.5
Mean blood cholesterol level / mmol dm −3
*P45028A0828* 33
(i) Describe the relationship between blood cholesterol level and the risk of
death from coronary heart disease for people living in Asia.
(1)
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................. . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . .
(ii) Describe how this relationship differs from that shown for people living in
Australia and New Zealand.
(2)
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................. . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................. . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . .
(iii) Suggest one explanation for the difference in the relationship for these two
groups of people.
(1)
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................. . . . . . . . . . . . . . . . . . . . .
(iv) Suggest how the information in the graph could be used to improve the
health of people living in Asia.
(1)
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................. . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . .
Turn over
34
13.2014 Jun Q5
5 The bar graph below shows the number of deaths from cardiovascular disease (CVD)
for some European countries in 2008.
Ukraine
Russian Federation
Estonia
Women
Slovakia
Men
Greece
Netherlands
Spain
–
–
800 600 400 200 0 200 400 600 800 1000 1200
Number of deaths per 100 000 of population
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................. . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . .
(b) Suggest why the deaths from CVD are expressed as the number of deaths per
100 000 of population.
(1)
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................. . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . .
35
(c) (i) Using the information in the bar graph, compare the number of deaths for
men with the number of deaths for women.
(2)
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................. . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . .
(ii) Suggest explanations for the differences in the number of deaths from CVD in
these countries.
(4)
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................. . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................. . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................................................................ . . . . . . . . . . . . . . . . . . . .
Turn over
36
14. 2014 Jun Q5
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)
*P42910A01428*
37
(b) The bar chart below shows how the number of risk factors affects the risk of
developing CVD.
3.5 –
2.5 –
2.0 –
1.5 –
0.5 –
0.0 –
–
–
0 1 2 3
Number of risk factors
(i) Using the information in the bar chart, describe the relationship between the
number of risk factors and the risk of developing CVD.
(2)
(ii) Suggest one change in diet, other than reducing saturated fats, which could
help reduce the risk of developing CVD.
(1)
Turn over
38
(c) Statins can be used to treat CVD.
Give one risk associated with the use of statins.
(1)
(d) Diuretics are antihypertensive drugs used to treat some people with CVD. They
cause an increase in fluid loss from the body by stimulating urine production.
Suggest how diuretics can help reduce the risk of CVD.
(2)
*P42910A01628*
39
IAL Topic 1C : Cardiovascular disease
Marking Scheme
1.2020 Jan Q6
4
4
2. 2019 Oct Q1
4
3. 2019 Jun Q2
4
4. 2019 Jan Q2
4
4
5. 2018 Jan Q3
4
6. 2017 Jun Q4
4
4
7. 2017 Jan Q2
4
5
8. 2016 Oct Q3
5
9. 2016 Jun Q4
5
5
10. 2016 Jan Q3
5
11. 2015 Jun Q4
5
12. 2015 Jan Q3
5
13. 2014 Jun Q5
5
14. 2014 Jan Q5
5
5