Association between awakening cortisol levels and cardiovascular performance in sugarcane rural workers.

Sudden deaths without known causes have been reported among rural workers in the last decade, especially in low and middle-income countries. The current study aimed to analyse the association between awakening cortisol response and cardiovascular performance in rural workers before and after the harvesting period. Fifty-four rural male workers and 48 residents were included (non-rural workers) from a sugarcane production area in São Paulo, Brazil. Morning salivary cortisol were analysed before and 7 months after the beginning of burnt sugarcane harvesting. Cardiovascular performance (blood pressure, pulse pressure and heart rate HR) was evaluated using the Incremental Shuttle Walking Test (ISWT). Our findings revealed a negative association between CAR and cardiovascular performance in rural workers at the harvesting period. Specifically, morning cortisol levels significantly increased after seven months of intense harvesting activity, allied to improvements in physical performance, systolic blood pressure and heart rate reactivity to a cardiopulmonary task. No association was observed in the resident group. Altogether, these findings suggest that, at least in the short-term, rural workers presented an adaptive response to the physical demands of sugarcane harvesting work. Longitudinal studies are essential to investigate the long-term effects of harvesting activity on rural workers' health.