Lifestyle risk indicators and health promotion priorities among adults with heart failure in Hargeisa Somaliland: a hospital based cross sectional study

Background Evidence on lifestyle-related health-promotion needs among people receiving heart- failure care in Somaliland is scarce. This study estimated the prevalence of self-reported cigarette smoking, lack of regular physical activity, and self-rated dietary patterns among adults with heart failure attending a specialist cardiac center in Hargeisa. Methods A hospital-based cross-sectional survey was conducted in March 2026 among 200 adults with a clinical diagnosis of heart failure who were recruited at Indo Gargaar Metro Cardiac Center. A structured, interviewer-administered questionnaire assessed self-reported cigarette smoking, regular physical activity, and self-rated diet. Categorical data were summarized using frequencies, percentages, and 95% Wilson confidence intervals (CIs). The analysis was descriptive because all participants had heart failure and no comparison group or longitudinal outcome was available. Results Of the 200 participants, 149 (74.5%) were men, 98 (49.0%) were aged 60 years or older, and 148 (74.0%) lived in urban areas. Self-reported cigarette smoking was reported by 90 participants (45.0%; 95% CI: 38.3–51.9), while 117 reported no regular physical activity (58.5%; 95% CI: 51.6–65.1). Nine participants (4.5%) rated their diet as healthy, 147 (73.5%) as moderate, and 44 (22.0%) as unhealthy. Overall, 191 (95.5%; 95% CI: 91.7–97.7) did not rate their diet as healthy. Conclusion Self-reported cigarette smoking, reported inactivity, and perceived suboptimal diet were common in this clinic-based sample. Heart-failure services should incorporate standardized lifestyle screening, individualized education, and culturally appropriate smoking-cessation, activity, and nutrition support. These findings describe patients receiving specialist care and should not be interpreted as population prevalence or as evidence that the measured behaviors caused heart failure.