Why can not I activate the ECG function in my country?

As I don’t have the relevant hardware to test here I can only suggest you reboot your devices, re-check the setup steps described in Taking an ECG with the ECG app on Apple Watch Series 4 - Apple Support and if necessary Contact Support for further assistance.

These are the countries authorized to use the App:

• Austria
• Belgium
• Croatia
• Czech Republic
• Denmark
• Finland
• France
• Germany
• Greece
• Guam
• Hong Kong
• Hungary
• Iceland
• Ireland
• Italy
• Luxembourg
• Netherlands
• Norway
• Poland
• Portugal
• Puerto Rico
• Romania
• Slovakia
• Spain
• Sweden
• Switzerland
• United Kingdom
• United States
• US Virgin Islands

Today Canada and Singapore were added.

When your country's health agencies approve the ECG functionality, I'm sure Apple will include your country in its next software update. Keep in mind that your country may require Apple to jump through hoops of paper work and testing that are different from what it has already done, and of course qualified local legal help will need to be acquired just to correctly fill out the paper work.

Andaroec wrote:

the problem is that I bought an Apple Watch 4, for this function because I am hypertensive, and I get this joke that only in certain countries can you get that application

The ECG function only checks for AFib.

Apple has been upfront from the very beginning about what countries the ECG feature would work in.

i think you can with the new watch os update that can out yesterday

julieda wrote:

Today Canada and Singapore were added.

Which means... Software Update Day again. Thanks for the heads up

So Canada was added today but there is still no “setup” on Health data, etc. And, yes, I have installed the latest updates for my XR. Anything else to suggest?