The Samsung Galaxy Watch 4 supports a wide array of health tracking and fitness features. However, some of these features are not available to all users. For instance, the ECG and blood pressure features are restricted to certain regions. In addition, you can't use these features when the watch is paired with a non-Samsung phone, even in supported regions either. Thankfully, there's a workaround to get these features across all regions, even on non-Samsung devices. If you're using your Galaxy Watch 4 with a non-Samsung phone or don't have access to the features due to regional restrictions, here's how you can enable ECG and blood pressure on your Galaxy Watch 4.

How to enable ECG and blood pressure features on the Samsung Galaxy Watch 4

To enable ECG and blood pressure monitoring on the Samsung Galaxy Watch 4 in unsupported locales or with a non-Samsung phone, you'll need to install the modded Samsung Health Monitor app from XDA Senior Member Dante63. You will have to install the modded app on both your phone and the Galaxy Watch 4.

However, the process isn't as straightforward as it might sound. To make things easier, we've outlined the instructions in detail. But before you proceed any further, download all the required files from the link below.

Download the Modded Samsung Health Monitor App

The Google Drive folder linked above includes all the files you'll need to enable ECG and blood pressure monitoring on your Galaxy Watch 4. It also includes a couple of guides to help you out in case you get stuck somewhere during the process.

Ensure you have the Galaxy Wearables app installed on your phone and paired with your Galaxy Watch 4. Also, be sure to install the Galaxy Watch 4 plugin from the Play Store.

Install the modded Samsung Health Monitor app on your phone

Installing the modded Samsung Health Monitor app on your phone is a pretty straightforward process. All you need to do is locate the modded app in the Drive folder linked above (labeled Phone.WearOS.SHM.MOD.X.X.X.XXX.dante63.apk) and transfer it to your phone's root directory.

  1. On your phone, use a file explorer to navigate to the root directory and locate the modded APK.
  2. Tap on the modded Samsung Health Monitor APK to install it. You should now see a permissions pop-up to install apps from unknown sources. Follow the prompts to head over to the device settings and allow app installations from the file manager.
  3. You should instantly see another pop-up with an Install button. Tap on it to install the app, and then tap on Done on the following pop-up to complete the installation.

That rounds up the easy part. Now, let's move on to the complex bit, which is installing the modded Samsung Health Monitor app on the Galaxy Watch 4 using ADB.

For the purpose of this post, I'm using a OnePlus 10 Pro and the stock OxygenOS MyFiles app. If you don't have a file explorer on your phone, you can download any of the options listed in our collection of the best file manager apps for Android.

Install the modded Samsung Health Monitor app on your Galaxy Watch 4

Installing the modded Samsung Health Monitor app on the Galaxy Watch 4 requires ADB. If you're not familiar with installing ADB on your PC, you'd be glad to know that Dante63 has provided a simple solution.

  1. Open the Watch SHM MOD WearOS folder in the Google Drive folder linked above. Then, open the READ ME -ADB Manual instructions folder and extract the contents of the ZIP file in the folder to your desktop. Double-click the Minimal ADB Fastboot executable from the ZIP file and follow the instructions provided in the installation wizard to set up ADB.
    Screenshot of command prompt window with ADB and Fastboot commands.
  2. A command prompt window should pop up as soon as you complete the installation. If it doesn't, simply navigate to the directory when you installed Minimal ADB Fastboot and double-click on the file labeled cmd-here.
  3. Before you proceed any further, enable the ADB debugging and Debug over Wi-Fi settings on your Watch. Follow these steps to enable the debugging options.
    1. Enable Developer Options on your Galaxy Watch 4. To do so, head over to the device settings on your watch, scroll all the way down to the About watch option, and tap on it.
    2. On the following page, select the Software option and then tap on the Software version on the following page a few times to enable the Developer mode.
    3. Jump back to the device settings and select Developer options. Then, tap on the toggles next to the ADB debugging and Debug over Wi-Fi settings to enable them.
    4. Once connected to Wi-Fi, tap on the active connection and note down the IP address mentioned on the following page.
      Screenshot of Galaxy Watch 4 IP address.
  4. Once you're done enabling the debugging options, head back to the Minimal ADB and Fastboot command prompt window on your PC and type "adb connect" followed by the IP address from the previous step.
    Screenshot of command prompt window with adb connect command.
  5. You should instantly see a prompt on your watch asking you if you'd like to allow debugging. Select OK if you just want to allow debugging one time, or Always allow from this computer if you don't want to repeat the process again.

    If your watch is configured to connect to a Wi-Fi network, it should now automatically connect to the saved network and show you the IP underneath the Debug over Wi-Fi option. If you're not connected to Wi-Fi, head over to the Connections option on the main settings page and connect to a Wi-Fi network. Make sure you're connected to the same Wi-Fi network on your PC. You can also use your phone's mobile hotspot for this purpose.

  6. Now, set your watch aside, type the following ADB command, and hit Enter to install the modded Samsung Health Monitor app on the watch. For this command to work as intended, you need to have the modded Samsung Health Monitor APK in the same directory as the file labeled cmd-here, i.e., the folder in which you installed ADB. Also, replace the X in the command mentioned below with the current version number of the APK.
            adb -s "IP address" install Watch.SHM.MOD.X.X.X.XXX.dante63.apk
        
  7. Once the app is installed successfully, you should see "Success" in the command prompt window. Now, disconnect from ADB using the following command.
            adb disconnect
        

You should now be able to see the modded Samsung Health Monitor app in your watch's app drawer. When you open the modded app on your phone, your Galaxy Watch 4 should connect automatically, and you should be able to see the Blood Pressure and ECG tabs. You can follow the instructions provided in the app to set these features up. Once that's done, add the ECG and blood pressure tiles to your watch, and you're good to go.

Before you start using these features, make sure to disable ADB debugging on your Galaxy Watch 4, or it will impact its battery life. To do so, head back to the Developer options and tap on the toggle next to the ADB debugging option.

It's also worth mentioning that since this method uses a modded Samsung Health Monitor app, you might encounter some expected issues. In addition, you won't be able to sync blood pressure data between your watch and the Samsung Health app on your phone. However, we have a simple workaround to enable BP sync on the Galaxy Watch 4 as well. You can try it out by following the given link, and if you still face any issues, you can drop your concerns in the XDA Forums thread linked below.

Samsung Health Monitor mod XDA forum thread