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Hello Jill,

Modifications for students in this style or that style should be something imparted to prospective teachers during their training, until such a time as we are all working with healthy people or are all willing to refer ailing students to an appropriate style/teacher for their particular issue. So answer number one should almost always be - "ask the teacher who trained you". If that person does not have an answer AND the teacher wishes to continue to work with students presenting therapeutic issues then it may be appropriate to consider an additional course of training in therapeutic yoga.

There is a complete protocol for dealing with students who have high blood pressure (HBP). That should be administered by a teacher trained in it. While there are modifications for inversions that serve students with high blood pressure, I am not aware of any asana limitations for such students with basic twists. In fact, a brief Sarvangasana with a head wrap, when done properly, is quite good for HBP.

Anecdotally, I have heard that while students in inversions have higher bp they tend to have lower BP after the inversion then they did before it. And, after all, that's sort of the point.

The last bit of this is that the more rapid an asana class moves the more difficult authentic, effective modification would become. The increased pace makes it quite problematic. That is in addition to the fact that students also experience an exponential reduction in their ability to feel the pose (the more rapid the movement). Ergo you have selected a style of practice that by its very nature, does not allow much "room" for modification.

Ideally, if there's concern, the student should not be discouraged from yoga (or asana in this case) but rather directed to a teacher that can modify the practice for that student both as a result of their training and the style in which they teach.