There are three diseases classified as primary autonomic failure (PAF), multiple system atrophy, Parkinson's disease, pure autonomic failure. Compensatory mechanisms preventing from decrease in blood pressure are inefficient in PAF. Among half of the patients with PAF occur orthostatic hypotension (OH) and supine hypertension (SH), which are the cause of deterioration of life quality. The treatment is based on modification of lifestyle and pharmacotherapy. Drugs used in OH may exacerbate SH and vice versa.