A 67-year-old woman comes to the physician for a 3-month history gradually worsening pain in her left knee. She describes the pain as dull and aching, worse in the evenings after a day of activity, and improves somewhat with rest. She has difficulty climbing stairs and reports stiffness in the morning that usually resolves within 15 minutes. There are no recent traumas or illness. On examination, her knee show bony enlargement and crepitus with movement. There is no significant warmth, erythema, or effusion noted. The joint range of motion is mildly reduced, particularly with flexion. Her hands show bony nodules at the distal and proximal interphalangeal joints. Radiographs reveal joint space narrowing and osteophyte formation. Which of the following is most likely to have prevented this patient’s condition?
A) Blood pressure management
B) Elimination of intense exercises
C) No specific preventive measures
D) Smoking cessation
E) Weight loss
