Hello there and thank you for using HCM. I carefully read your question and I totally understand your concern. Don t worry, Its nothing serious. As you describe, my opinion is that we are dealing probably with exstrasystoles. These are electrical impulses generating from parts of the heart different from that of normal sinus rhythm. They cause this escaped or skipping beats. You may feel a palpitation, an anxiety sensation or like a beat is skipping. There are different reasons that may generate an extrasystol from simple emotional strees to different pathologyes like anemia, hyperthyroidism ect. Hypertension and exstrasystoles are independent from each other meaning that you may have extrasystoles without having hypertension, you may have hypertension without extrasystoles or both of them. The fact that you have a low blood pressure is a good news you don t have to worry about this. In fact this is our goal when we treat hypertension. Now we have to deal with this skiiping beats. My opinion as a cardiologist is that we are not talking for something urgent. I will recommend you to tell your symptoms to your treating doctor in your next visit to make some simple examinations like a blood analyze, your thiroid hormones. Of course if I was your treating I will recommend a holter monitoring to register and see what happens with your rhythm during these symtoms. If you feel that your heart is beating in a chaotic way it is advisable to make an electrocardiogram in that exact moment to your nearest cardiologist. In mean time avoid coffee and caffeine products because they exacerbate this symptoms. When we document and see what kind of a rhythm problem is this we can talc about treatment. Hope I was helpful. Wish you good health. Best Regards