Insulin resistance, chronically elevated blood glucose, elevated triglycerides, visceral adiposity, and chronic inflammation directly damage arterial endothelium and promote atherogenic plaque formation and rupture.

Study: Effects of fluvastatin on insulin resistance and cardiac morphology in hypertensive patients

This study found that a medicine that improves the body’s response to insulin also lowered heart strain and exercise blood pressure — even without changing cholesterol. This suggests that high blood sugar and insulin resistance can hurt blood vessels, just like the claim says.

Study: Correlations between the cumulative metabolic score for visceral fat and its dynamic trajectories with the onset of cardiovascular disease in middle-aged and older adults: findings from two prospective cohorts.

People with long-term high belly fat, high blood sugar, and high triglycerides were much more likely to develop heart disease over time — showing these problems really do harm arteries and lead to dangerous plaques.

Study: Insulin Resistance is Associated With Skin Microvascular Dysfunction and Reduced Circulating Endothelial Progenitor Cells in Hypertensive Patients

High blood sugar and fat metabolism problems (insulin resistance) were linked to fewer repair cells and worse blood flow in tiny arteries, meaning the inner lining of blood vessels is getting damaged — which is the first step toward dangerous plaque buildup.