Heart disease used to be considered a man's problem, but women have closed the gender gap.

Heart disease used to be considered a man's problem, but women have closed the gender gap.

These days, heart disease actually kills more women than men, Dr. Melike Arslan told a crowd of more than 100 women — and a few men — during a program Thursday evening at the Medford library.

Arslan said women fear breast cancer, but they're far more likely to die of heart disease, the leading cause of death for American women. Heart attacks and strokes kill at least 10 women for every one who dies of breast cancer, and one in every four women dies of heart disease.

"Sixty percent more women die of heart disease and stroke than all cancers combined," Arslan, a cardiologist at Providence Medford Medical Center, said.

Heart disease presents unique problems for women. Their symptoms differ from men's, and their traditional role as caregivers and nurturers often prevents them from seeking treatment when symptoms arise.

"Women tend to ignore their symptoms," Arslan said, "and their symptoms are vague."

As a result, women may suffer more heart damage if they survive the initial episode.

"The more you delay, you're losing (heart) muscle," she said. "Every minute counts."

Arslan said women tend to have a wider variety of heart-attack symptoms than men. Men typically describe deep chest pain during a heart attack, and many talk about feeling as if an elephant is sitting on their chest. Women may feel similar chest pain, but they can also have pain just under the breastbone, or in the middle of the chest, or on either arm or between the shoulder blades.

Women also may feel the pain of a heart attack in the upper abdomen, where it's often mistaken for indigestion, or in the neck or jaw. With such a wide range of symptoms, physicians sometimes fail to recognize a woman may be having a heart attack.

Arslan encouraged women to take steps to reduce their risk of coronary artery disease, heart attack and stroke with the same approach that has been preached to men for decades — eliminate fatty foods and stay active physically.

"It all comes down to diet and exercise," she said.

That means eating less meat and more grains, vegetables, fruits and fish, along with foods such as almonds and walnuts, which can help lower cholesterol levels in the blood that are associated with heart disease.

She noted that studies of people who eat a "Mediterranean" diet (little red meat, lots of fruits, vegetables, beans, bread, pasta and potatoes) have shown they have lower death rates from cardiovascular disease and cancer, and lower incidence of Parkinson's disease and Alzheimer's.

While some foods have been proven to promote heart health, other highly touted supplements have shown no proven benefits in research studies, Arslan said. These include: garlic, selenium, folic acid, beta carotene and vitamin C.

Supplements such as vitamin E may even be harmful when taken excessively (more than 400 international units of vitamin E per day).

She also encouraged women to abstain from tobacco, noting that smoking is the single most preventable cause of death. Tobacco increases blood pressure, encourages blockages to develop in blood vessels, and reduces the body's supply of "good" cholesterol.

"Women who smoke are at much higher risk — more than twice — for heart attack and stroke," she said.

Some of Arslan's information surprised many women in the crowd. She noted, for example, that recent studies indicate moderate consumption of alcohol (the equivalent of three to six glasses of wine per week) can increase the body's "good" cholesterol. She was quick to say, however, "if you don't drink, I wouldn't recommend you start drinking" just to increase the good cholesterol.

At the same time, new studies have shown that same level of alcohol consumption may make women about 15 percent more likely to develop breast cancer. (Whether the alcohol was wine, beer or liquor made no difference.) Researchers who conducted that study said because more women die of heart disease than breast cancer, the overall benefits of moderate alcohol use probably outweigh the risks.

Many of the women in the audience said they recognized the need to pay more attention to heart health.

"I just celebrated my 58th birthday," Jeanne Morgando of Medford said. "It's time to get educated. My dad passed at 60 from an aneurysm in his aorta."

Others said they had heard similar messages before, but agreed that it was valuable to hear them again.

"I have a family history of heart disease," Jill McKean of Phoenix said. "I just got my Medicare card. I'm a nurse. It's time to get serious about this.

"It's all about motivation," McKean said. "All things in moderation, but we all know that. We all want a magic pill."

Bill Kettler is a freelance writer living in Rogue River. Reach him at bdkettler@gmail.com.