Objective To explore the relationship between the fundus vascular changes with the stage and risk stratification of essential hypertension(EH) and the cardiac function.Methods One hundred patients with EH in our hospital from April 2011 to March 2016 were selected and divided into the control group(n=29),Ⅰ-Ⅱ group(n=56) and Ⅲ-Ⅳ group(n=15) according to the Keith-Wagener fundus grading.The stage and risk stratification of EH (mild,moderate,severe),cardiac function indexes[left ventricular end-diastolic inner diameter (LVEDD),left ventricular wall thickness (LVPWT),interventricular septum thickness (LVST),left ventricular mass index (LVMI),carotid intima-media thickness (IMT),left ventricular ejection fraction (LVEF)] were compared among 3 groups.Results The proportions of mild hypertension in the control group,Ⅰ-Ⅱ group and Ⅲ-Ⅳ group were 55.17％,21.43％ and 6.67％ respectively,the proportions of moderate hypertension were 31.03％,30.36％ and 26.67 ％ respectively,which of severe hypertension were 13.79 ％,48.21 ％ and 66.67 ％ respectively,the differences were statistically significant(x2 =5.568,P=0.019).The cardiac indexes of LVEDD,LVPWT,etc.had statistical differences among the control group,Ⅰ-Ⅱ group and Ⅲ-Ⅳ group(P＜0.05).The fundus vascular changes were positively correlated with the stages and risk stratification of EH (r=0.742,P =0.002),while LVMI (r =0.674,P =0.028) and IMT (r =0.598,P =0.014) were negatively correlated with LVEF(r=-0.623,P=0.035).Conclusion The fundus vascular changes have close correlation with the stage and risk stratification of EH and cardiac function,which could be used as an important index for judging the hypertensive severity and target organ damage situation