TOPIC 1: LIFESTYLE, TOPICS COVERED
• The Circulatory System
• Water as a Transport Medium
•
HEALTH AND RISK •
The Cardiac Cycle
Atherosclerosis
• Blood Clotting
For the Edexcel Biology A Level (SNAB) • Defining Risk
• Study Design
• Risk Factors for CVD - Blood Pressure,
Energy Balance, Smoking, Weight, etc.
• Treating CVD including Drugs
• Biomolecules
• Cholesterol
The Circulatory System
Key Terminology and Equations
Term Definition
Mass Flow All the particles in a liquid move in one direction through tubes due to pressure
differences
Transport Medium Fluid that transports substances around the body
Transport System The vessels which carry a transport medium around the body
Open Circulatory Blood circulates in large open spaces. A simple heart pumps blood out into cavities
System surrounding organs, where exchange occurs. During diastole, blood is drawn back
into the heart through small valved openings
Closed Circulatory Blood is enclosed within vessels; blood travels under high pressure and moves
System faster, thus increasing the efficiency of substance exchange
Ventricle → Arteries → Arterioles → Capillaries → Venules → Veins → Atrium
Single Circulatory Contain two heart chambers; blood passes through the heart once, as these
System systems are located in smaller-sized organisms
Double Circulatory Blood flows into the heart twice after passing through the lungs, as a larger pressure
System difference is needed to cause vigorous blood flow to compensate for the greater
size and metabolic rate of the endotherm, where pressure is lost in capillary beds
and is restored by the second journey through the heart
Cardiac Cycle Sequence of events during a heartbeat
Elastic Recoil Ability of arteries to expand during systole and relax during diastole
Myocardium Muscular tissue of the heart
Cardiac Output Volume of blood pumped by the heart per minute
Stroke Volume Volume of blood pumped from the left ventricle per beat
Coronary Arteries Arteries which supply the heart with its own blood supply needed for respiration
Atheroma Deposit containing cholesterol and other chemicals which is formed within the wall
of an artery
Cholesterol Important lipid constituents of cell membranes, but a high proportion in the blood
is associated with an increased risk of coronary heart disease.
Thromboplastin Enzyme involved in the conversion of prothrombin to thrombin
Prothrombin A soluble protein plasma secreted in the liver using Vitamin K
Thrombin An enzyme which catalyses the conversion of fibrinogen into fibrin
Fibrin Protein which forms long, insoluble strands
Myocardial Commonly known as a heart attack; when blood flow decreases or stops to a part
Infarction of the heart, causing damage to the heart muscle
Angina Chest-pain, usually experienced during exertion, which causes oxygen-deprived
myocardium to respire anaerobically
Arrhythmia Irregular heart beat, which can itself lead to heart failure. This can be important in
the diagnosis of coronary heart disease
Aneurysm If part of an artery is narrowed and hardened, blood can build behind it. The artery
bulges and an aneurysm forms, which will rupture, resulting in blood loss and shock,
which could prove to be fatal
Risk The probability of an occurrence for some event, usually in the context of hazards
Heart Beat (bpm) = 60 ÷ Period of One Cardiac Cycle (s)
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The Structure of the Circulatory System
Blood is circulated through the
body through arteries and
veins. The walls of these
vessels contain collagen, a
fibrous protein, which makes
them strong.
Each time the heart contracts,
blood is forces into arteries and
elastic fibres allow for
stretching. During diastole, the
elasticity causes recoil, forcing
blood forward. The pulsing
flow leads to the capillaries,
where rapid exchange occurs.
In the veins, low pressure
draws blood back. Backflow is
prevented by valves when
skeletal muscles relax.
Vessels Arteries Arterioles Capillaries Veins and Venules
Function Oxygenated blood to Extend to connect Site of Deoxygenated blood
organs capillaries to arteries exchange back to heart
Structure Thick and smooth muscle and One or two layers of Single layer of cells Thin muscle and elastic
elastic layers, with endothelium smooth muscles with form endothelium in tissue with outer coat of
further narrowing lumen. thin elastic layer an extensive network collagen fibres
Lumen Very Narrow Narrow Narrow Wide
Pressure Very High High Low Very Low
Valves No No No Yes – prevent backflow
Water as a Transport Medium
• Water is a polar molecule, making it a useful transport medium, due to unevenly
distributed charge - the oxygen ends has a slight negative charge as it is more
electronegative, and the hydrogen end has a slight positive charge
• The negatively charged end of a water molecule attracts the positive ends of
surrounding molecules; hydrogen bonding holds water molecules together and
explains properties such as water’s liquid state at rtp
• Ionic and polar molecules dissolve in water, allowing reactions to occur in the
cytoplasm, but also allowing substances to be transported in the water. Hydrophobic substances,
such as lipids, must combine with proteins to be transported
• Water also allows temperature regulation, as the specific heat capacity is very high, due to the
hydrogen bonding requiring large amounts of energy to be overcome. Even extreme environmental
variations will have little effect on the internal conditions due to this property of water
The Cardiac Cycle
• Contractions of the myocardium generate pressure changes which result in the orderly
movement of blood
• Blood flows from an area of high to low pressure unless flow is blocked by a valve
• Events on the right and left sides of the heart are the same, but pressures are lower on the left
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Atrial Systole: Due to pressure increase,
Elastic recoil AV valves open and 70% of blood leak
into the ventricles. Atrium contracts and
remaining 30% of blood forced into
ventricles
Ventricular Systole: When the atria are
relaxed, ventricle walls contract, forcing
blood out. Pressure of blood forces AV
vales to slam shut and opens the
semilunar valves. Blood passes into aorta
and pulmonary veins
Diastole: The ventricles relax and the pressure of ventricles falls below that of arteries due to elastic
recoil of relaxing heart. Blood under high pressure in the arteries causes semilunar vales to shut. Blood
from the vena cava and pulmonary veins fill the atria due to low pressure and the cycle repeats
Atherosclerosis and Blood Clots
If arteries become very narrow or blocked then they cannot supply enough blood to carry oxygen to
tissues, causing limited function. The fast-flowing blood under high pressure in the arteries makes them
susceptible to risk of damage to the walls, so only arteries get atherosclerosis
1. Endothelial lining of the artery is damaged by high blood pressure or toxins caused by smoking
2. This triggers an immune response; white blood cells, which travel to the site of damage, cause the
accumulation of LDL cholesterol, which forms the bases of an atheroma
3. Calcium salts and fibrous tissues cause the build up of a hard plaque underneath the endothelium
4. This causes a positive feedback loop, as the atheroma reduces the diameter of the lumen,
increasing blood pressure further and further damage elsewhere to the endothelium is more likely
5. The hard plaque causes the artery wall to lose elasticity and harden, known as atherosclerosis
6. If the plaque ruptures, collagen in the endothelium is exposed, activating platelets in the blood,
causing a change in shape to form a platelet plug at the site of damage
7. This triggers a cascade of chemical changes known as coagulation to form a blood clot
8. Prothrombin, a soluble plasma protein, synthesised in the liver using Vitamin K, is converted into
the enzyme thrombin by the enzyme thromboplastin under the presence of calcium ions
9. Thrombin catalyses the change of soluble plasma protein fibrinogen into insoluble fibrin
10. Fibrin tangles red blood cells and sticky platelets together in a mesh, forming a blood clot
• Blood clots can leave areas ischaemic and unable to respire. They can also travel as an embolus
• If blood supply to the brain is interrupted, a stroke is caused, with numbness, confusion or paralysis
• Narrowing of the coronary arteries limits the volume of blood reaching the myocardium, resulting in
chest pain called angina, experienced during exercise, when the heart has to respire anaerobically
• If blood supply to the heart is stopped, this can cause a heart attack
Risk Factors for CVD
Risk is defined as the probability of an occurrence for some event, usually in the context of hazards.
Likelihood Population
Risk can be calculated as a percentage (Population ×100) or as 1 in Likelihood
.
Risk is overestimated if the occurrence is: involuntary, unnatural, unfamiliar, dreaded, unfair or small.
Risk is underestimated if the occurrence is voluntary and familiar, or consequences are long term.
Correlation between two variables may suggest risk factors but does not guarantee causation
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Risk factors can be deduces using different studies. A cohort study follows a group over time, and
compares exposure to risk factors to people with and without a condition to draw a conclusion. A case
control study compares the history of exposure to risk factors for individuals with an without a condition
to find a conclusion. A good study should have:
• a clear aim and hypothesis to be tested
• representative sample without selection bias
• repeatable method which should produce valid and reliable results
• clearly defined disease diagnosis
• large sample size, to produce results that could not have occurred by chance
• consideration of other variables, such as age and gender
Blood Pressure
Hypertension is one of the most common factors in the development of CVD, as it increases the
likelihood of the occurrence of atherosclerosis. Blood pressure is the measure of the hydrostatic force
of the blood against the walls of a vessel, dependent on the diameter of the lumen and the pressure
caused by the vessels. Pressure in the arteries is higher during ventricular systole (systolic pressure) and
lower during diastole (diastolic pressure).
A sphygmomanometer is a device used to measure blood pressure, consisting of a cuff and a
manometer to measure pressure. Blood pressure is measured in mmHg, and is recorded as two
numbers, systolic pressure over diastolic pressure.
Contact between blood and the walls of a vessel causes friction, impeding blood flow, called peripheral
resistance. As the capillaries offer a greater surface area, blood is slowed and pressure falls. Fluctuations
in pressure are caused by the cardiac cycle of the heart. Elastic recoil maintains pressure during diastole.
Blood pressure increases as the lumen’s diameter decreases, therefore any factor that causes
constriction, such as adrenaline or high-salt diet, increases blood pressure.
At the arterial end of a capillary, blood is under pressure, forcing fluid and molecules from the plasma
through the capillary walls into intercellular spaces, forming tissue fluid. This tissue fluid allows for
exchange of substance; most returns to the capillary due to an increased water concentration gradient
but some is drained by the lymph capillaries. If blood pressure is higher than normal, more fluid may
be forced out, accumulating fluid within tissues, causing oedema, causing swelling, and is a symptom
of high blood pressure.
Smoking
• Smoking damages the lining of the arteries, leading to a build-up of an atheroma, narrowing the
lumen. This can cause angina, a myocardial infarction or a stroke
• CO in tobacco reduces O2 concentration in the blood, meaning the heart must pump harder to
supply oxygen to meet demand
• Nicotine in cigarettes stimulates the body to secrete adrenalin, making the heart beat faster and
raising blood pressure
• Blood is therefore more likely to clot, increasing risk of CVD
Weight and Physical Activity
Research shows that being overweight or obese can raise blood cholesterol levels and increase blood
pressure due to excess weight carried. Likelihood of developing Type II Diabetes, where the body does
not secrete enough insulin or the body fails to respond to the insulin produced, increases, as
continuously high blood glucose levels from frequent sugar-rich food reduces sensitivity of cells to
insulin. Physical activity, however, can reduce blood pressure, control weight and raise HDL levels and
is therefore recommended.
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Energy Balance
The obesity epidemic is in part due to the sedentary modern lifestyle and the high proportions of fats
and carbohydrates in diets.
The Health Department publishes dietary guidelines to get the energy balance right. Dietary Reference
Values are not recommendations, but include an estimated average and a reference nutrient intake,
providing a range for a healthy diet to fall into. Whilst carbohydrates and fats are required, overeating
can lead to obesity.
The basal metabolic rate (BMR) is the constant supply of energy to maintain the essential body
processes. This is higher in males, heavier people, younger people and more active people.
• A negative energy balance occurs due to excessive exercise, stress or high BMR. This can
lead to weight loss as energy stored in the body is used to meet demand
• A positive energy balance occurs when a person routinely eats too much or does too little
exercise. Additional energy is stored and the person gains weight
mass (kg)
BMI is calculated using the formula . A BMI of 25-29.9 is overweight, and 30 and above is
height2 (m2 )
normal. A BMI of 20-24.9 is normal, and anything below this is underweight. There is evidence to
suggest that waist-to-hip ratio is a better measure, with a strong positive correlation with heart attack
rate. It is measured by dividing waist circumference at the rib margin by the hip circumference around
the buttock. Waist-to-hip ratio should be lower than 0.90 for men and 0.85 for women.
Genetic Risk Factors
Apolipoproteins are the protein component of lipoproteins, formed in the liver with important roles in
stabilising lipoprotein structure and receptor recognition. The APO gene cluster has association with
CHD, but the numerous mutations and their effects make it impossible to estimate the effect of a single
gene, as CVD is multifactorial.
APOA Major protein in Helps remove Mutations in apoA gene associated with low HDL
HDL cholesterol to the liver levels and reduced cholesterol removal, increasing
for excretion CHD risk
APOB Major protein in Transfers cholesterol Mutations in apoB result in higher LDL levels and
LDL from blood to cells higher CVD risk
APOE Major protein in Remove cholesterol to Three alleles produce E2, E3 and E4. E4 slows
HDL and VLDL the liver for excretion removal of cholesterol and so increases risk of CHD
Antioxidants, Salt, Coffee, Alcohol and Stress
• During reactions in the body, unstable radicals result when an atom has an unpaired electron.
Radicals damage many cell components, causing cancer and CVD. Vitamins like C, E and beta-
carotene provide hydrogen atoms to stabilise these radicals. Fruits and vegetables are a good
source of these antioxidants
• High salt diets cause the kidneys to retain water, and the higher fluid levels elevate blood pressure
• In the long term, caffeine, contained in coffee, may slightly increase risk of CVD as it is a stimulant,
causing activity but also vessel constriction, increasing blood pressure slightly
• Stress triggers the secretion of adrenalin, causing the arteries to constrict, raising blood pressure.
Stress can also lead to overeating, poor diet and higher alcohol consumption
• Heavy drinking raises blood pressure, contributes to obesity and causes irregular heartbeat, due to
tissue damage, and the liver cells responsible for detoxification are damaged. Glucose and lipids
are left in the blood and excess alcohol forms VLDLs. However, moderate alcohol levels lead to
higher HDL levels
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Reducing CVD Risk
Risk of CVD can be reduced by smoking cessation, maintaining low blood cholesterol, BMI and normal
blood pressure, taking more physical exercise and moderate alcohol use.
Drugs to Treat High Blood Pressure
Drugs can be used to treat people with excessively high blood pressure and evidence of CVD. These
may have side effects and vary in effectiveness in different people
• ACE Inhibitors: antihypertensive drugs which reduce the synthesis of angiotensin II. This
hormone causes vasoconstriction of blood vessels to control pressure. The ACE inhibitors
prevent the hormone from people produced from its inactive force I, lowering blood pressure
➢ Side effects may include dizziness, abnormal heart rhythms and lower kidney function
• Calcium Channel Blockers: antihypertensive drugs which block the calcium channels in the
muscle cells of the arterial lining. For the muscle to contract, calcium must pass through these
channels into the muscle cells. Failure of calcium to enter the cell prevents muscular
contraction of vessel walls, lowering blood pressure
➢ Side effects may include headaches, swollen ankles and abnormal heart rhythms
• Diuretics: increase the volume of urine produced by the kidneys, reducing excel fluids and salts
from the body. This reduces plasma volume and cardiac output, lowering blood pressure
➢ Side effects may include dizziness, nausea or cramps
Reducing Blood Cholesterol Levels
• Statins are used to inhibit an enzyme involved in LDL cholesterol production, reducing risk of CVD
• Large studies show that risk of heart attack lowers by 33%
• There are very low increases in risks of death by non-vascular causes and gastronomical and
respiratory cancers
Anticoagulant and Platelet Inhibitory Drug Treatment
• These drugs prevent the formation of an arterial blood clot for people at high risk of CHD or a
stroke. The tendency for platelet aggregation and clotting is reduced by these drugs.
• Aspirin reduces the stickiness of platelets and the likelihood of a platelet plug forming. This drug
may cause serious bleeding in combination with clopidogrel, another inhibitory drug, and this risk
outweigh the benefits.
• Warfarin is an anticoagulant, affecting the synthesis of clotting factors. The benefits are higher than
with aspirin but risk of bleeding is higher.
Dieting
An ideal diet to reduce CVD risk would have:
• an energy balance
• reduced saturated fat
• more polyunsaturated fats
• reduced cholesterol and salt.
• increased intake of fruit and vegetables. Non-starch polysaccharides, known as soluble fibre,
are found in these. They are partially digested to form a gel to trap and prevent absorption of
cholesterol. They also contain antioxidants
• consumption of oily fish, which contain omega-3 fatty acids. They have polyunsaturated fatty
acids with the first double bond between the 3rd and 4th carbons. These are essential for cell
function and reduce heart disease risk
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Biomolecules
Carbohydrates are found as monosaccharides, disaccharides or polysaccharides. Monosaccharides are
the simplest sugar units. Disaccharides are the sugars formed when two monosaccharides are joined
by a glycosidic link formed by a condensation reaction. A polysaccharide is a carbohydrate molecule
consisting of many sugar units linked by these glycosidic bonds. Oligosaccharides have 3-10 units.
This is an α-glucose monosaccharide, which you should be able to draw out.
During a condensation reaction, the two identical glucose monosaccharides
react to form the disaccharide maltose, eliminating water. These two
monomers are joined by a glycosidic bond. To split this disaccharide, water
is added in a hydrolysis reaction.
There are three common disaccharides: maltose, sucrose and lactose.
Maltose = Glucose + Glucose Sucrose = Glucose + Fructose
Lactose = Glucose + Galactose
Starch is a polymer made of glucose monomers. There are two possible structures within starch
Amylose Has 1,4 glycosidic links. Coils into a compact helix due to hydrogen bonding, making it a good
storage molecule
Amylopectin Has 1,4 glycosidic links to form helices. However, it has 1,6 glycosidic bonds to form side
branches within the molecule
Name Structure and Chemical Properties Biological Role and Use
Glucose Sweet, soluble, crystalline Substrate for cellular respiration to release energy
Monosaccharide
Maltose Sweet, soluble, crystalline Found in Germinating Seed
Disaccharide Substrate for cellular respiration to release energy
Sucrose Sweet, soluble, crystalline Transport molecule in translocation through the phloem
Disaccharide Substrate for cellular respiration to release energy
Starch Insoluble polysaccharide with Storage molecule of glucose found in plants
amylose and amylopectin Broken down to produce glucose for respiration
Glycogen Insoluble polysaccharide with many Compact storage molecule in the liver, broken down to
1,6 glycosidic links and higher raise blood glucose levels. Structure with many short
proportions of amylopectin branches allows for rapid hydrolysis. Insoluble, meaning
it does not affect the osmotic gradient.
Lipids contain carbon, hydrogen and oxygen, though with lower carbon
proportions. They form fats for energy and electrical and thermal insulation,
phospholipids and cholesterol for membranes and form the basis of steroids.
A triglyceride is formed when three fatty acids are linked to a glycerol molecule
by ester bonds formed in condensation reactions.
Saturated fats contain the maximum number of hydrogen atoms, with long
straight chains which pack closely together. Monounsaturated fatty acids have
one double bond between carbon atoms in each chain, while polyunsaturated
acids have many. C=C bonds introduce kinks in the chain, preventing chains from
packing closely together, with weaker intermolecular forces.
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Cholesterol is a short lipid molecule, and is a vital component of cell membranes with roles in structure
and function. Steroid sex hormones such as progesterone and testosterone are produced from
cholesterol. Cholesterol is made in the liver from saturated fats and is obtained in our diet.
Cholesterol is combined with proteins to form soluble lipoproteins to be transported around the body
• High Density Lipoproteins (HDLs) have a higher percentage of protein compared with LDLs and
are made when triglycerides from unsaturated fats combine with cholesterol and protein. HDLs
transport cholesterol from body tissues to the liver to be broken down, lowering blood
cholesterol levels and helping to remove fatty plaques of atherosclerosis.
• Low Density Lipoproteins (LDLs) have a lower percentage of protein and are made when
triglycerides from saturated fats combine with cholesterol and protein. LDLs are the main
cholesterol carrier in the blood. They circulate and bind to receptor sites of cell membranes to
be taken in. Excess LDLs overload these receptors, resulting in higher blood cholesterol levels.
Statured fats may also reduce the activity of LDL receptors, so the LDLs are not removed,
further increasing blood cholesterol. This LDL can be deposited in artery walls to form
atheromas
It is desirable to maintain a higher level of HDL and a lower level of LDL. Eating a low-fat diet which
particularly avoids saturated fats will reduce total blood cholesterol, and especially LDL cholesterol.