Abstract: Objective To construct a nomogram model to predict subclinical target organ damage（STOD） in patients with essential hypertension（EH） based on flow-mediated dilation（FMD） of the brachial artery. Methods Clinical data of 529 patients with EH who were diagnosed without STOD based on first medical visit were retrospectively collected in the First Affiliated Hospital of Fujian Medical University from August 2000 to May 2016. FMD was measured in all patients using high-resolution vascular ultrasound doppler, and FMD ≤7.1% was defined as endothelial dysfunction. The risk factors for the subsequent occurrence of STOD in patients with EH were screenedusing Cox regression analysis, and then a nomogram was constructed. The predictive value of the nomogram was assessed by the area under curve（AUC） of receiver operating characteristic curve, the calibration degree of the model was validated by the calibration curve, and the clinical applicability of the model was assessed by decision curve, Kaplan-Meier curve and riskplot. Results Within a median follow-up time of 23（95%CI 3-95） months, there were 195 patients with new onset of STOD. The Cox regression included a total of five indicators, including endothelial dysfunction（HR=2.44, 95%CI 1.78-3.34）, elderly patients（HR=1.53, 95%CI 1.11-2.12）, abdominal obesity（HR=1.44, 95%CI 1.06-1.97）, smoking（HR=1.84, 95%CI 1.27-2.69） and high level of glutamyl transferase（HR=1.78, 95%CI 1.21-2.61）. Based on the above condition, a nomogram prediction model was constructed. The AUC values predicted by the model for STOD were 0.72（95%CI 0.65-0.79）, 0.71（95%CI 0.65-0.77） and 0.74（95%CI 0.68-0.80） at 1, 3 and 5 years, respectively（all P＜0.05）, indicating good prediction ability. In addition, the calibration curve showed that the model was well calibrated, and the decision curve, Kaplan-Meier curve and riskplot all verified the clinical applicability of the constructed nomogram. Conclusions This study combined FMD with traditional indicators to build a nomogram that can predict the occurrence of STOD in EH patients. The model has good discrimination ability, which can help clinicians to identify high-risk groups, and develop early prophylaxis and treatment strategies.