As Edexcel unit 1 Jan

Jan 2023 class

m Topic 1A
Topic 3C CVS
Chemistry
for biologist
18/11/2023
Part 1
Risk
Corellation and causation
Error bars
Modifiable and non modifibale risk factors
 Cardiovascular health and risk Read to under stand

Non infectious disease: not caused by pathogen and can’t be transmitted

Example , CVD , inherited diseases , deficiency diseases ……..
Factors that can either increase or decrease the risk for these diseases

Risk Probability that an event can take place

In one group compared to another

1 in 5 to get the pink ball

Risk factor Lab research : found that smoke

Smoking contains substances such as nicotine

Correlation Lab test to
…damage endothelium …atheroma …
Increasing risk of CVD
Increase risk find a plaque …narrowing …increase blood
Strong tendency for two sets of causation pressure …increase risk of thrombosis
data to change together Factor directly causes a
specific effect
Study :
1. Identify risk factor …of certain disease
2. Look at people who has the same factors
3. Compare the risk of disease with average risk for whole population
 Types of risk

Actual risk
Perceived risk .
Probability of an event occurring at a certain time
Subjective judgment
Example : motorcycles and car death risks .
That people make about severity of a
risk = not always actual risk .
Explain why some people underestimate some risk factors : Like risk of death for airplanes.
1. Long time for symptoms to appear
2. Experience contradicts with research Affected by

3. Over and under estimation of risk factors with one another . A) approval

4. Risk is applied in groups rather than individuals. B) enjoyment

C) familiarity.
Why preceived risk should be close to actual

If people know that they are at risk, they can try to modify their life style .

Like they could do a blood test to check the progression .

Also some medications can be prescribed to slow down progression .

If perception is greater than actual ,an unnecessary change may be made .

 Correlation Causation
% of
CVD When one factor directly causes a specific
effect

Lack of exercise
A strong tendency for two sets

Smoking
Change in one variable directly results in a
of data to change together

Diet
change of another variable
( indirect )
Risk factors Proved by lab test

A change in one variable is accompanied by a Increase in blood cholesterol level

change in another variable causes an increased risk of
Proven by statistical analysis. . atherosclerosis.
Example :
Smoking / lack of exercise these are risk factors
for CVD
Yet there is no prove that one is a cause of the other

Correlation Cause
High blood pressure ………….atheroma Cause
……….narrowing
High fat intake ……………………..CVD
High blood cholesterol level

Increase in blood pressure Cause

 Studies carried to show the correlation between a risk factor and a disease

1. Based on large sample size

2. Investigate one variable with other variables should be kept constant ( constant variables )
3. Carry study over a long time at least one year …longitudinal study
4. Add safety precaution..like excluding people with high risk of CVD / choose people with no
risk of CVD) Write this in
case he asks
u to carry a
Exposure study
Case
Case control study
Cohort / longitudinal study No Exposure
Questionnaires
Start with a normal group of people Control

Split into
A) group exposed to the risk factor
B) group remain unexposed to the risk factor
Study should be applied for long time , on same
group of individuals
Meta data analysis
When data from all avilable studies in a
particular area are analysed ..to give
more reliable evidence
You start with two groups
A) group with disease
B) group without disease
Collect data through questionnaires
Age, HDL :LDL , life style , smoking habits ,
family history , gender , body mass
Advantage : easy , fast , large sample size
Disadvantages : some people don’t say the truth ,
somepeople may forget
1.Valid : ……controlled variables + repeat ( measure the degree of reliability )

2.Reliable ……experiment repeated more than once an getting similar results

What would make results unreliable
A) difficult to control all variables / risk factors
B) unreilable estimate of risk factors ( people may lie about data )

3. Precise ….measurements ( how close measurements of same item are to each other )

4. Accuracy ….close measurements is the true or accepted value

5. Biased when scientist is paid by someone with a vested interest in a specific result , so its important to know
who carried the research and who funded it and where it was published .

6. Evaluation Evaluate data

Represent data and measure reliability using error bars 1. Controlled variables …other risk factors are that
increase risk of CVD not included such as …
2. Sample size
3. Time / duration of testing
4. Mean value and SD ..statistical test
5. Under estimation …not saying the truth v
6. Repeat
7. Data correlation and not a causation
Unreliable No mean value

A) difficult to control all variables / risk factors

B) unreliable estimate of risk factor ( ex number of cigaret
smoke ) ..people might lie about data .

Controlled variables …validity

Large sample / repeat …reliability

For edexcel
Add one extra point

Reliability :
Comment on both
A) sample size / repetition / average or mean value / error bars
B) controlled variables
1 . Measuring degree of Reliability using SD / error bars.

1 . Mean value is calculated …so data is reliable

2. Assess degree of reliability
By size of error bars …the larger the error bar the more the deviation from mean value / more spread out of data ..so
data is less reliabile
3. Assess the significant or non significant difference between data SD ( standard deviation )
If error bars over lap ..so no significant difference deviation from mean value
If error bars don’t over lap …so there is a significant difference
If error bars touch ..so less significant difference
Most reliable .
Shortest error
bar . Data is
Least reliable,
Less deviating
from mean longer error bar ,
value data is more
Mean value deviating from the
mean value .
High blood pressure

Lack of exercise is a higher risk factor

Lack of exercise

over stress for CVD .

Yet no significant difference, overlapping.
Diet

Stress
Smoking

Risk of CVD
 Smoking Diet Low level of High fat Low vitamin C intake
exercise intake

1. Calculated the mean value ….so data is reliable

2. B ( diet ) is most reliable , shortest error bar so less deviation from mean value
3. E ( low vitamin C ) is the least reliable has the longest error more so more deviation from
mean value .
4. there is a significant difference between d on e on risk of CVD ..
5. There is no significant difference between a and b where error bars overlap .
1 .detecting significant difference between data

SD / error bars overlap …no SD / error bars overlap …no SD / error bars dont overlap …so there
significant difference significant difference is a significant difference

1. Draw error bars ..given SD value……..

Given mean value is 13 , S.D is o.5cm

2. Comment on size of error bar ………longer error bars ……more data are
spread / variable from the mean value ……….so less reliable results .

3. Compare data / bars

Overlapping …..so no significant difference l
No overlapping …there is a significant difference
21/ 11/2023
Part 2
Risk factor ( modifiable and non )
Treatment
Cp vitamin C
 Risk factors for CVD ( multifactorial disease)

Modifiable Non Modifiable

1. Smoking 1. Gender : below 50 years males are at higher risk than females from developing CVD . Due to presence
2. Alcohol intake of oestrogen ….however after menopause risk become equalized.

3. Lack of exercise 2. Age : as we get older , the blood vessels loose part of their elasticity and they become narrower …

4. Diet and energy intake increase blood pressure

3, genes :
5. High blood pressure
1. Tendency to develop hypertension
6. Stress
2. Cholesterol balance in body
7. Low HDL to LDL
3. Arteries easily damaged

1. Smoking

A) nicotine : 1) increase in adrenaline concentration in blood ….increase in heart rate .

2) constriction of blood vessels …………..increase in blood pressure
B) CO: irreversibly bind to haemoglobin forming carboxyhaemoglobin …..less oxygen carried to body
cells and heart muscle .
C) smoke particles : damage endothelium of arteries resulting in atheroma …..atherosclerosis part …..
( inflammatory response) .

2. High blood presure

Hypertension …….persistent high blood pressure above 140/90

How to measure …mercury manometer // sphygmomanometer .
Factors increasing blood pressure : smoking , stress . High salt intake . Obesity , saturated fat intake
3. Lack of exercise Energy input > energy out put
Excess Energy stored as fats LEO GER
Increased risk of CVD OIL RIG
• as exercise is needed to lower blood cholesterol level
Vitamin c Other toxic
• Release stress
molecules
• Strengthen heart muscle
( free radicals )
• Balance lipoprotein ( increasing HDL: LDL ratio) / decreasing LDL to HDL ratio
• Thus decreasing risk of atherosclerosis

4. Diet

Diet affects several risk factors for CVD ( like blood pressure and blood cholesterol level )
A) vitamin C …….antioxidant ( prevent oxidation of other molecules = allow reduction of other
molecule )……..by losing electrons / donating electrons ….to reduce free radicals ……MORE vitamin C
B) salt …increase blood pressure ……less salt
C) alcohol and caffeine consumption ….less alcohol l LDL
D) saturated fat intake …less saturated fat
1) LDL ( saturated fat , cholesterol , protein )
2) HDL ( unsaturated fats , cholesterol , proteins )
LDL
Why do we need to take into consideration the total
HDL
cholesterol level and HDL level ?

Having higher HDL to LDL ration…..lower risk of CVD

Having higher LDL To HDL ratio….higher risk of CVD
5. Stress Increase adrenaline ….increase in heart rate …..increase in blood pressure

Vitamin C Vegetables and fruit …..reduce risk of CVD

1) antioxidants ..reduce free radicals which are toxic substances that damage the cells ..where they donate electrons to
free radicals

2. Antioxidants reduce plaque and atheroma formation …so reducing damage of blood vessels

1. Repeated and take average ..reliable

Read 2. Comment in degree of reliability on
commenting on size of error bars
3. Comment whether there is a
significant difference between data
Read
 Why we need to take into consideration the total cholesterol level and HDL level ?

1. Because the total cholesterol level is considered as a risk factor.

2. As the LDL is associated with development of heart disease .
LDL carrier the cholesterol from liver to your cells …where it build / binds to cell membrane ..yet excess of LDL
build up on walls of arteries causing them to be stiffer and narrower .
3. Also HDL is useful , take excess cholesterol from body cells back to liver to be broken down and removed from
body
SO Having higher HDL to LDL ratio…..lower risk of CVD
Having higher LDL To HDL ratio….higher risk of CVD

Explain how increase in fat intake in diet and less physical activity lead to increase in risk of CVD ?

Energy input > energy out put

1. High energy intake which is higher than energy output ( less fat burnt)
2. So excess fat stored in body causing increase in body weight
3. Obesity increase risk of diabetes type 2 , increase blood pressure and increase LDL to HDL ratio, thus
increase blood cholesterol level .
4. Risk of high LDL to HDL ratio ..increase in total cholesterol level , Solution
A) damage the endothelium of arteries . Energy output >energy input
B) stimulating inflammatory response …formation of atheroma . Exercise , weight loss
C) narrowing lumen of arteries and lose of their wall elasticity programme .
D) increasing risk of CVDs .
Why result of a questionnaire for CHD is an underestimate?

1. People usually under estimate their mass / level of stress / how much they smoke .
2. Because total cholesterol level / blood pressure / LDL are estimates
3. Other risk factors are not included .

Reducing risk of atherosclerosis and CVD ?

1. Reduce stress and get more exercise

2. Take early actions before there is a clear evidence of the early signs of atherosclerosis in teenagers , if
known factors are already in place
3. Eating a balanced diet with plenty of fruits and vegetables to help prevent atherosclerosis
4. Stop smoking to help maintain healthy weight and avoid high blood pressure .
1. Energy budget Energy input ( food intake ) < energy out put ( exercise )

E input > energy out put E output > energy input

Weight gain ( may lead to obesity ) Weight loss

1. So follow weight loss programs aim to reduce fat intake and increase regular exercise
So that E output > E input
2. Solutions might include include taxes on food , town planning to make walking and cycling easier
3. Education people to prevent childhood obesity

2. Measure healthy weight

A. BMI ( body mass index )

Problems with body mass index

1. BMI doesn;t recognise difference between muscles and fats

2. BMI values underestimate body fat in older people who have lost their muscle mass
3. So BMI is not a good predictor of CVDs on its own but combined with other factors

Why some people with high BMI don’t believe that they are at risk of developing CVDS

1. BMI is not reliable indicator of obesity to those who have high muscle mass ( higher muscle to fat ratio)
Example : athlete’s , you won’t recognise difference between muscles and fats .

2. Lack of education and awareness that BMI is linked to CVDs .

3. People with high bMI don’t show any symptoms of CVDs .

Obesity

Male > 0.9

Waist size (Cm )

Solution So they will use waist to hip ratio=
Hip size
Improvement
Female >0.85
 Treatment
C) Sympathetic nerve inhibitors ' ACE inhibitors
A
Controlling blood pressure
Sympathetic nerve …….responsible for stimulation
Antihypertensives
of constriction of arteries
Drugs for lowering blood pressure
A) diuretics Kidney release enzyme renin ( normal situation ) 2
Renin
1 Angiotensinogen Angiotensin I
Remove excess salts and fluid in urine…by secreted from
In active plasma protein kidney upon Inactive protein ACE

decreasing the water reabsorption in kidney

inhibitor
detecting a
decrease in blood ACE
pressure Angiotensin
Decrease the volume of blood converting enzyme
Thus decrease blood pressure
Benefits
So less chance of damage walls of arteries
1. Prevent constriction of blood Angiotensin II
3
Hypotension , kidney problems and headache. vessels Active protein
Stay dilated stimulate
2. So decrease in blood pressure
B) beta blockers constriction of blood
Block receptors of adrenaline on the 3. So reduce risk of
vessels
surface of heart muscle …..so heart atherosclerosis
Receptors for 4. Decrease risk of CVD
doesn;t respond to adrenaline ,,,so
adrenaline
contract less frequently/H.R
Risk '
Heart ….decrease blood pressure ….by
1. Blood pressure might go too low ( hypotension)
muscle acting on nervous system
2. Nausea, dizziness , constipation , swollen ankle
B
Controlling blood cholesterol level

Statins Plant stanol esters

Lower blood cholesterol level
Naturally occurring plant products
Inhibit the synthesis of cholesterol in liver by inhibiting
Similar structure to cholesterol
enzyme involved in cholesterol synthesis in liver ..thus
Reduce absorption of cholesterol
increasing HDL to LDL ….decrease LDL to HDL
from small intestine
ratio . ..thus reducing risk of CVD
So reduce LDL

Potential risk
1. Serious but rare side effects including muscle
inflammation , liver damage
2. Kidney damage
3. Nausea
4. Constipation / diarrhea
5. Muscle pain
6. Insomnia
C
Drugs preventing clotting

1. Anticoagulants
( warfarin)
Prevent formation of clot by interfere with formation of prothrombin ……..so no
thrombin …….no fibrin formed ……reduce effectiveness of platelets , reduce risk
of clot formation so less chance to block arteries..
risks :
1. Internal bleeding , nausea , stomach ulcer , dizzness , headache .

2. Platelets inhibitor
Prevent platelets coagulation like aspirin

Prevent platelets becoming activated.

Prevent formation of blood clot
So reducing risk of blockage of blood vessels / stroke / heart attack
 Core practical 2 Vitamin C content investigation

Procedure :
1. Extraction of fruit juice ….crushing and add distilled water to extract vitamin C .
2. Independent : different extracts of fruit juice with different vitamin C content .

3. Controlled variables :
Fruits same age , same mass / volume of the extract , same storage conditions , same concentration of DCPIP .

4. Methodology
Titration of the fruit juices by adding DCPIP to juices drop by drop and mix gently upon DCPIP
adding each drop where the color of DCPIP will change from blue to colorless .

5. Dependent :
Measure the volume / number of drops of DCPIP, added for the blue color to
remain / colorless to change to blue . …
reduction of DCPIP with vitamin C)

6. Standardization : compare the sample to standard solution of known vitamin C concentration

Repeat using 1% of vitamin C solution so compare the volume of DCPIP decolorised by fruit
juice with the volume decolorised by standard solution of vitamin C . Vitamin C
sample
10 mg vitamin C ( standard solution ) ……..5 ml DCPIP
End point : Add till blue color of DCPIP persist
X mg of unknown solution ………10 ml DCPIP
 Read
Independent …different extracts
E DCPIP
Controlled variables ……….same conc of DCPIP
Methodology …..titration
Vitamin C is antioxidant
= DCPIP ….reduced ..colorless
Blue …colorless
Keep adding DCPIP …..till the blue color remain
=
Standardisation ……compare to a solution of
known vitamin C concentration

-
1% X%
Vitamin C = Vitamin C
sample sample
5 cm3 DCPIP
-

10 cm3 DCPIP
End point : Add till blue color of DCPIP persist
=

Colorless I End point

DCPIP ..reduced Blue color turned
DCPIP Vitamin C
Blue Antioxidant
colorless
TIP
40
+ - de
17 DCPIP reduced
DCPIP Blue color will persist
Blue
End point : Add till blue color of DCPIP persist
 Read

DCPIP DCPIP Volume of

Fruit of same age DCPIP
Same mass needed for
Same volume of extract
the blue
Same storage conditions
color of
Same concentration of DCPIP
DCPIP to
Titration persist …
the higher
the
concentrat
DCPIP Vitamin C Colorless
ion of
Blue
vitamin C
End point

Sample of known
Vitamin C concentration of (Blue) DCPIP is reduced
sample vitamin C
Measure the volume of DCPIP used for
Antioxidant the blue color to remain
1. Non infectious disease
2. Definition of risk
Check list
3. Understand that correlation is used with risk factors such as smoking , stress, alcohol, high fat intake , high salt
intake , obesity …..risk factors showing a correlation with increased risk of CVD .
4. Define perceived risk .
5. Explain why people underestimate some risk factors .
6. Studies carried to show the correlation between a risk factor and disease .
A) longitudinal study
B) case control study ( majority of questions) …questionnaire.

6. How to make results valid ( repeat using larger sample , controlled variables ( biotic and abiotic)
7. Reliable ..getting similar results
8. Accuracy…….. measurements .
9. Biased ( enhyaz)

10. Draw error bars . ….compare degree of reliability in respect to size of error bar
Figure if there is a significant difference between data or not. …overlapping

11. Non modifiable risk factors ( gender , age , genes + reason)

12 . Modifiable
A) smoking Check list
Nicotine , CO, smoke particles +reason

B) lack of exercise
Importance. Of exercise.
Effect of decrease in physical activity + increase in fat in take ( 5 marks)

C) diet
1. Vitamin C …antioxidant + keywords
2. Saturated fats …..why take into consideration total cholesterol level and HDL level ? …4 marks
Why questionnaire for CHD is under estimate ? .
3. Salt
4. Alcohol

E) stress …( adrenaline )
F) high blood pressure 14.treatment
15. Vitamin C ( write plan an investigation)
13. How to reduce risk of atherosclerosis.