Objective • This study aims to determine the variations in myocardial work among patients with essential hypertension at varying risk levels by analyzing the left ventricular pressure-strain loop. Additionally, this research aims to investigate the potential diagnostic significance of myocardial work parameters in identifying myocardial dysfunction in patients with essential hypertension. Methods • We conducted a study with 79 patients who have essential hypertension and 30 healthy adults. The essential hypertension patients were categorized according to their risk level, with 10 patients in the low-risk group, 11 in the medium-risk group, 23 in the high-risk group, and 35 in the very high-risk group. We included 30 healthy adults in the study as a control group. Clinical data such as height, weight, and blood pressure were collected for all groups. Routine echocardiographic dynamic images were collected, and speck tracking echocardiography was performed to analyze global longitudinal strain and myocardial work parameters were detected by the left ventricular pressure–strain loop. Finally, the global work index, global constructive work, global wasted work, global work efficiency, and global longitudinal strain were calculated and compared among groups. The correlation between blood pressure and myocardial work parameters was analyzed. Results • Compared with the control group, interventricular septum thickness was thickened in the medium-risk groups, high-risk groups, and very high-risk groups, P < .001). There was a negative linear correlation between global work efficiency and blood pressure (systolic and diastolic, and a positive linear correlation was observed between blood pressure and global work index, global constructive work, and global wasted work. Conclusion • Left ventricular pressure–strain loop can be used to evaluate changes in left ventricular myocardial work of essential hypertension patients in the early stage and with different risk stratifications. [ABSTRACT FROM AUTHOR]