For decades, doctors and runners shared a comfortable belief: if you ran marathons, your heart was bulletproof. This was known as the "Bassler hypothesis," the idea that finishing a 26-mile race gave you a "get out of jail free" card against heart disease. However, as modern heart scans improved, doctors were met with a shock. The very people who were the fittest on the planet—lifelong marathoners and cyclists—often showed more "rust" or buildup in their heart pipes (arteries) than people who sat on the couch.