Fildena 50 contains sildenafil citrate as its active ingredient — the same drug found in Viagra — and its effects on the heart are mainly a result of how sildenafil works in the body. Here’s a clear summary of how it can impact heart health:  How Sildenafil (Fildena) Affects the Cardiovascular System ???? Vasodilation and Blood Pressure Fildena works by relaxing blood vessels (vasodilation), which increases blood flow to certain areas (like the *****). Vasodilation also lowers blood pressure slightly in most people. This isn’t usually dangerous in healthy individuals, but it can be significant in people already taking blood-pressure-lowering medicines or with low baseline blood pressure.  Heart Rate Changes Some people may experience palpitations or a mild increase in heart rate, mainly as the body compensates for lower blood pressure. True arrhythmias (abnormal heart rhythms) are rare but have been reported, especially in individuals with existing heart disease.   Important Safety Considerations   Contraindication with Nitrates Fildena must not be taken with nitrates  used for chest pain or heart conditions because the combination can cause a dangerous drop in blood pressure that could lead to fainting, heart attack, or stroke.   Pre-Existing Heart Conditions People with unstable angina, recent heart attack or stroke, severe low blood pressure, or certain heart rhythm disorders should generally avoid Fildena unless a doctor approves it after careful evaluation. ***** Activity Itself ***** activity increases heart rate and blood pressure, which can stress the cardiovascular system. Some reported serious events (heart attack, stroke) occurred during sex rather than being clearly caused by the medication itself.