CVD requires a bunch of events to happen in sequence, I always felt like it was a combination of risk factors + luck that make a heart attack or aneurysm happen.

1. High blood pressure damages walls of arteries and veins

2. LDL Cholesterol gets into the damaged walls

3. LDL gets oxidized

4. White blood cells engulf oxidized LDL and form plaques

5. Hardened plaques chill, they are bad but not deadly, if a plaque breaks off you are probably dead.

Sugar is gonna contributes to 1 - 3, especially 3 it seems way more guilty of than fat. The one big thing that opened my eyes was that most of the LDL you get is going to be produced by your own liver. Regulating how the liver produces it is going to have a bigger impact than directly eating less/more of it.

It is kind of a luck thing though, you could eat like shit and never have all the events occur just due to dumb luck, or you could be a fit 45 year old and for whatever reason you get a plaque that breaks off and you aneurysm and die.

Consuming cholesterol doesn't normally change the level of cholesterol in your bloodstream - it simply leads to your body producing less cholesterol. Unless you're consuming gigantic amounts, or have some problems with your cholesterol regulation, dietary cholesterol is completely safe. It's only if your blood work shows elevated cholesterol levels that you need to start paying attention to cholesterol intake. This is in fact very similar to what happens to blood sugar levels, in fact.

Pretty much every health authority will tell you that high blood sugar damages blood vessels, thereby enabling the formation of said plagues.

Sugar causes inflammation, and inflammation damages arteries. It is this damage that then leads to accumulation of fatty deposits, as damaged arteries basically lose the protective layer (think of equivalent to a non-stick coating). But that doesn't mean dietary fat is what actually caused the plaque.

Poor dental health also contributes and nothing pushes poor dental healthy like a high sugar diet.

Many such cases.

Yes.