What is the primary cardiovascular risk associated with diabetes?

• A. Accelerated atherosclerosis leading to ASCVD
• B. Hypertension alone
• C. Arrhythmias
• D. Valvular disease

Answer: (A)

Diabetes mainly increases cardiovascular risk by accelerating atherosclerosis, leading to atherosclerotic cardiovascular disease. Chronic hyperglycemia and insulin resistance promote endothelial dysfunction, systemic inflammation, and a dyslipidemic profile (high triglycerides and often low HDL with small dense LDL), all of which foster plaque formation and progression in arteries. When these plaques rupture or severely narrow vessels, they can cause coronary events, strokes, or peripheral artery disease—the core cardiovascular complications associated with diabetes. Hypertension and arrhythmias can accompany diabetes, but they are not the primary driver of the elevated cardiovascular risk; the dominant concern is accelerated atherosclerosis and ASCVD.