Taking aspirin at the earliest signs of a heart attack could save a surprising number of lives. Researchers writing in the Journal of the American Heart Association (May 1, 2024) created a population simulation model using data from randomized controlled trials. They found that if people took a single aspirin tablet as soon as they began to experience chest pain, 13,000 lives could be saved annually. What’s the fastest way to get this life-saving drug into your blood stream? We think soluble aspirin is the answer. In this article we will share some simple tricks to facilitate that process.
The Latest Data on Aspirin vs. Heart Attack:
We do not understand why many health professionals have turned their backs on aspirin. It seems to us that this very old medication (125 years on the market) is a life saver that deserves respect.
The authors of the article in the Journal of the American Heart Association article (May 1, 2024) state:
“Aspirin, an effective, low‐cost pharmaceutical, can significantly reduce mortality if used promptly after acute myocardial infarction (AMI). However, many AMI survivors do not receive aspirin within a few hours of symptom onset.”
These investigators point out that prompt aspirin usage is extraordinarily cost effective, with a price tag of less than $4 per year of life saved.
Many physicians worry that aspirin could increase the risk of bleeding.
However, these researchers took that possibility into account and concluded that:
“Benefits of reducing deaths post-AMI [acute myocardial infarction] outweighed the risk of bleeding deaths from aspirin 10 times over.”
When a Heart Attack Hits:
When someone is experiencing the classic symptoms of a heart attack (chest pain or pressure, pain spreading to the neck, jaw or arms, nausea or abdominal pain, shortness of breath, sweating, fatigue, dizziness), immediate action is called for. Often, though, people do not recognize the early symptoms or dismiss them as heartburn or something else. We have known people who have gone many hours or even days before they suspected something really bad was happening and headed for a hospital.
Emergency medical services recommend taking aspirin ASAP, along with immediately summoning an ambulance for emergency transportation to the nearest hospital. There is no time to waste.
Could Soluble Aspirin help?
An article in the Western Journal of Emergency Medicine (Dec. 2015) offers evidence supporting the use of aspirin to improve the likelihood of surviving a heart attack.
The investigators write:
“There is high-quality evidence demonstrating benefit of aspirin administration (162.5mg) in improving mortality among patients with an acute myocardial infarction (MI) [heart attack]. This reduction in long-term mortality is greatest when the aspirin is administered early.”
The question is: how quickly can a person with heart attack symptoms get aspirin into his system? This reader asks an important question.
Faster Action with Soluble Aspirin!
Q. Why isn’t there a soluble aspirin tablet available in the US? I carry two 325 mg tablets in my coin purse at all times and have read that one should take aspirin at the first sign of a heart attack, while simultaneously calling 911.
Is it better to dissolve the aspirin in my mouth or in water before ingesting it? Would soluble aspirin be more effective? Or is simply swallowing one or two aspirin with a glass of water equally effective?
A. We are not sure why soluble aspirin has never caught on in the United States the way it has in Europe, Australia and New Zealand (by the brand names Aspro and Disprin). Dissolvable aspirin is available in the U.S. only in combination products such as Alka-Seltzer or BC Powder.
Make Your Own Soluble Aspirin:
We have come up with a People’s Pharmacy homemade liquid aspirin solution. Here is the trick:
- Fill a glass with 6 to 8 ounces of club soda, seltzer water or “sparkling” water
- Drop a plain uncoated aspirin into the glass of fizzy water
- Add half a teaspoon of baking soda to help dissolve and buffer the aspirin (optional)
- For flavor and to help the dissolution process squeeze a bit of lemon juice into the mix (optional)
- Stir gently to make sure most of the aspirin is dissolved
Or Chew It Up:
You may be pleased to learn that simply chewing a standard 325 mg aspirin tablet for 30 seconds and then swallowing it with at least four ounces of water is a good way to get its effects quickly (American Journal of Cardiology, Aug. 15, 1999). This technique produces measurable anti-clotting benefits within five minutes, compared to 12 minutes after swallowing an intact pill.
Here is the conclusion:
“…many physicians and emergency medicine personnel have instructed patients with myocardial infarction to chew their initial dose of ASA [aspirin], and the 1996 ACC/AHA guidelines have encouraged this practice. The present pharmacokinetic/pharmacodynamic study now provides compelling scientific evidence to support this recent recommendation.”
If chewing regular aspirin is challenging, you can buy flavored chewable low-dose aspirin and achieve a similar effect. The recommendation of 162 mg would achieved with two baby aspirins (81 mg each).
In fact, a study that compared various forms of aspirin concluded:
“The results indicate that soluble and chewed aspirin inhibit platelet aggregation in a shorter period of time than does whole aspirin. The results suggest that chewing baby aspirin or taking soluble buffered aspirin may be the preferred route of administration for early platelet inhibition.” (Schwertner et al, Thrombosis Research, 2006)
More Confirmation That Soluble Aspirin Is Faster!
Here is a study that was published online in Thrombosis Research, Nov. 18, 2005:
Background:
“Early aspirin treatment is widely used to inhibit platelet activity and to reduce morbidity and mortality in patients presenting with an acute myocardial infarction or a stroke. A number of different aspirin formulations have been used for this purpose; however, a comparison of their effectiveness in inhibiting early platelet aggregation has not been determined.”
Conclusion:
“The results indicate that soluble and chewed aspirin inhibit platelet aggregation in a shorter period of time than does whole aspirin. The results suggest that chewing baby aspirin or taking soluble buffered aspirin may be the preferred route of administration for early platelet inhibition.”
Platelets are the sticky part of blood that lead to clots. “Inhibiting platelet aggregation” may reduce the size of a clot or help partially dissolve it before there is total blockage in a coronary artery. That could lead to greater tissue destruction.
Enteric Aspirin vs. Fast-Acting Aspirin:
Many people have enteric coated aspirin on hand. There are many brands that are designed to dissolve in the small intestine rather than the stomach. This is supposed to protect the stomach from irritation, but if such pills are swallowed whole, absorption will be delayed significantly.
Chewing an enteric coated aspirin tablet, however, might speed things up. A study from Japan found that chewed enteric coated aspirin tablets exerted an anti-clotting effect within 20 minutes (Journal of Pharmaceutical Sciences, Sept. 2011).
One Word of Caution!
Not everyone should automatically swallow or chew an aspirin pill at the first signs of a heart attack. Someone who is taking blood thinners/anti-coagulants should always check with the prescriber about this strategy long before a possible heart attack. That way the person will know in advance if soluble aspirin is a good or a bad strategy.
There is more information on aspirin in our free Guide to Key Aspirin Information.
Please share your own aspirin story in the comment section below.
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