Which of the following risk factors is associated with a twofold increase in the risk for CAD death and up to a sixfold risk for stroke?

Diabetes mellitus is well-established as a significant risk factor for cardiovascular disease, including coronary artery disease (CAD) and stroke. The association stems from various mechanisms, including the impact of hyperglycemia on blood vessels and the resultant inflammatory processes that accelerate atherosclerosis. Individuals with diabetes often present with other risk factors such as hypertension and dyslipidemia, which further compound the cardiovascular risk.

Research indicates that diabetes can lead to a twofold increase in mortality from coronary artery disease and up to a sixfold increase in the risk of stroke compared to individuals without diabetes. This heightened vulnerability is due not only to direct effects of elevated glucose levels on vascular health but also to the increased presence of other cardiovascular risk factors often seen in diabetic patients.

The other options, while also important risk factors for cardiovascular events, do not have the same level of evidence linking them to such a dramatic increase in mortality and stroke risk specifically associated with diabetes mellitus.