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In vascular smooth muscle cells, PDE5 inhibition by Vilitra 20 results in elevated levels of cGMP. Increased cGMP promotes the relaxation of vascular smooth muscle cells, thereby dilating blood vessels and improving blood flow. This vasodilatory effect is crucial not only for erectile function but also in conditions like pulmonary arterial hypertension, where enhanced pulmonary vascular resistance necessitates improved blood flow to the lungs.