Hypertensive palpitations are most often associated with hypertension-related arrhythmias, as hypertension can lead to left ventricular hypertrophy, and patients with left ventricular hypertrophy can experience more cardiovascular events, including arrhythmias and sudden death, and hypertension can lead to supraventricular arrhythmias and atrial fibrillation. About 25-50% of patients with hypertension develop atrial flutter or atrial fibrillation. When patients with hypertension develop heart failure, the hallmark is a slowing of the heart rate, and increased myocardial fibrosis and oxygen consumption result in an increased frequency of premature ventricular events and ventricular tachycardia. For the treatment of such patients, beta-blockers such as metoprolol and bisoprolol can be considered if the heart rate is fast and supraventricular arrhythmias such as atrial fibrillation and atrial premature occur. In addition, angiotensin-converting enzyme inhibitors or angiotensin receptor II antagonists such as irbesartan and benazepril can improve ventricular remodeling and reduce the symptoms of palpitations.