Q1)

a) i) D
ii) A
iii) B
iv) A

b) By controlling variables like age, gender and job of subjects of their experiment (male office
workers aged 40) and by having a control (no breakfast).

c) The graph shows that male office workers aged 40 that had no breakfast had a mean BMI of
26.9 kg ms-2 which is high compared to other types of breakfast. (4 types of breakfast with lower
mean BMI)

d) Cooked cereal had the lowest mean BMI between all types of breakfast which means that
people who have cooked cereal are the least overweight (most fit) and being overweight is
linked to high cholesterol levels and high blood pressure both of which increase the risk of
cardiovascular diseases like a stroke. Low cholesterol levels reduces the risk of forming
atheromas so less chance of hardening or blocking of arteries (so lower chance of CVDs).

Q2)

a) i) Higher blood pressure means increased risk of damaging the endothelium of the arteries. So
an inflammatory/ immune response happens. Cholesterol deposits which creates an atheroma.
Fibrin and collagen with calcium ions builds up and hardens the atheroma creating a plaque.
This causes the sclerosis. All of this hardens and narrows the artery which causes a higher blood
pressure which will lead to more atherosclerosis (positive feedback). a thrombus may form and
then block the artery which may cause a heart attack or a stroke.

ii) Smoking. Nicotine causes vasoconstriction which increases blood pressure which increases
the risk of CVDs occurring.

Age, arteries of old people lose their elasticity and narrow which increases the risk of being
damaged and forming an atheroma (atherosclerosis).

High intake of saturated fat, this causes a high LDL to HDL ratio which is linked with increased
risk of CVDs.

iii) 4.29 * 6000 / 100 + 4.48 * 6000 / 100 = 526

b) No, since the percentages of people using aspirin and the placebo who died are very close.
4.29% and 4.48%. The difference between them is just 0.19% which is 11 people in every 12000
which is a small number. In addition people who took aspirin were double as likely to have
bleeding into the digestive system which may be very dangerous. And there was no effect on the
incidence of strokes.
The amount of aspirin should be experimented more with, perhaps experimenting with higher
amounts for example 200, 300, 400 and 500 mg and changing the frequency of intake of aspirin.
Like twice a day for example.
Even if this increased the risk of forming ulcers (bleeding into the digestive system) it should be
acceptable since the number of bleeding in both groups was low according to the study and
heart attacks and strokes are way more dangerous. (but patients must be advised to take care).